Prognostic Factors of Okada et al for Adenocarcinoma of the Stomach

 

Exclusion criteria:

(1) positive surgical margins of resection

(2) invasion of esophagus

(3) no invasion of muscularis propria (prognosis for musosal or submucosal involvement is considered excellent)

 

Parameters associated with prognosis:

(1) depth of penetration

(2) duodenal invasion

(3) macroscopic appearance

(4) INF pattern

(5) lymphatic or vascular invasion

(6) fibrosis accompanying cancer

Factor	Favorable	Intermediate	Unfavorable
depth of penetration	muscularis propria or subserosa	NA	serosa
duodenal invasion	absent	NA	present
macroscopic appearance	advanced cancer simulating early cancer	Borrmann type I or II	Borrmann type III or IV
INF	alpha pattern	beta pattern	gamma pattern
lymphatic or vascular invasion	absent	NA	present
fibrosis accompanying cancer	abundant	some	absent

 

where:

• Borrmann type refers to the macroscopic appearance of the tumor based on examination of the mucosal surface, as described in the next section.

• I am not sure of the exact meaning of INF, but I assume it refers to the infiltrative pattern of tumor growth. The alpha pattern has an expansive growth pattern with a distinct border from the surrounding tissue. The gamma pattern has an infiltrative growth pattern with an ill-defined, indistinct border. The beta pattern is intermediate between the alpha and gamma patterns.

 

Interpretation:

• The more favorable factors the better for prognosis.

 

Limitations:

• I did not see status of lymph nodes mentioned.

• No mention was made of distant metastasis, but I assume these would all have a poor prognosis.