Background: Little is known about the clinicopathological findings in elderly patients with undifferentiated
advanced gastric cancer. The aim of this study was to clarify the clinical impact of clinicopathological
characteristics of those cancers in elderly patients.
Method: A total of 42 patients aged 80 years or older with advanced gastric cancer who had undergone
curative gastrectomy between 1998 and 2015 were included in this study. All patients were classified into
two principal subgroups based on histology: undifferentiated group and differentiated group. The two
groups were examined and compared with respect to the pathological findings and clinical outcomes.
Results: Of the 47 patients, 23 (49%) patients were in the undifferentiated group and 24 (51%) were in the
differentiated group. The undifferentiated cancer was less frequently located in the upper third of the
stomach than the differentiated cancer (4% vs 42%, P < 0.01). The frequency of the cancer with depth of
T4a was higher in the undifferentiated group than in the differentiated group (48% vs. 17%, P < 0.05). The
median number of metastatic lymph nodes in the undifferentiated group was more than that in the
differentiated group (3 vs. 1, P < 0.05). In short- and long-term outcome after curative gastrectomy, there
were no differences between the two groups.
Conclusion: In elderly patients, undifferentiated advanced gastric cancer may have more malignant
potential than differentiated cancer. However, by curative gastrectomy, the elderly patients with
undifferentiated advanced gastric cancer can be obtained the equivalent clinical outcome to those with
differentiated cancer.
Peer review report 2 on “Clinical impact of small advanced gastric cancer (≤ 40 mm) in elderly patients”
