Prognostic comparison of the pathological classifications of gastric cancer: a population-based study

Aims: There is controversy over the value of the pathological classifications of gastric carcinomas in the prediction of patient survival. This study was designed to assess the prognostic value of four widely used pathological classifications, in addition to classical prognostic factors. Methods and results: Records from the population-based registry of digestive tract tumours in the department of Cote d'Or (France) have been analysed. All available histopathological slides of gastric cancer resected between 1976 and 1985 were reviewed and classified according to World Health Organization (WHO), Lauren, Ming and Goseki pathological coding systems. A relative survival analysis was performed using a relative survival model with proportional hazard applied to net mortality by interval. WHO, Lauren or Goseki classifications were not found to be independent prognostic factors. In addition to advanced age group, depth of parietal involvement, nodal involvement, presence of metastases, tumour site and gross appearance of the tumour, the Ming's infiltrative type was associated with a lower survival. Conclusion: This study suggests an independent prognostic value of the Ming subtypes with respect to survival in patients resected for gastric carcinoma.