Title

Gastric carcinoma: typing, staging, lymph node and resection margin status on gastrectomy specimens

Document Type

Article

Department

Pathology and Laboratory Medicine

Abstract

Objective: To determine the extent and stage of gastric carcinoma on gastrectomy specimens in terms of type, grade, location, depth of invasion, resection margins and lymph node status.STUDY Design: Descriptive study.PLACE AND DURATION OF STUDY: Section of Histopathology, Department of Pathology, Aga Khan University, Karachi during 2005 and 2006.MATERIALS AND Methods: A 100 consecutive gastrectomy specimens received during the study period, in which resection was done for gastric carcinoma were included. Exclusion criteria were gastrectomy performed for gastrointestinal stromal tumor (GIST) and gastric lymphoma. Specimens were examined according to standard techniques. The reporting incorporated all relevant parameters including gross examination, tumor location, type and grade, depth of invasion, surgical resection margins and lymph node status. Staging was done according to the TNM staging system. Restults: Fifty three (53%) tumors were located in the distal part of the stomach and 35 (35%) in the proximal part. In 12 (12%) cases, tumor was diffusely involving the entire stomach. Histologically, the tumors were signet ring type in 63 (63%) cases and intestinal type in 37 (37%). At least one peripheral resection margin was positive in 29 (29%) cases. Sixty six (66%) cases were T3, 30 (30%) were T2, 3 (3%) were T1 and one case (1%) was T4. Twenty four cases (24%) were N0, 35 (35%) were N1, 27 (27%) were N2 and 14 (14%) were N3.CONCLUSION: Gastric cancer was at very advanced stage in these patients with full thickness involvement of the gastric wall and positive lymph nodes. It is thus essential to detect and surgically treat these cancers in an early stage. Better surgical techniques are required to ensure negative peripheral resection margins and removal of adequate number of lymph nodes, so that proper staging can be performed.

Publication

Journal of the College of Physicians and Surgeons Pakistan

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