This study was done to define clinical features for the different pathological types of advanced gastric carcinoma. One thousand one hundred three patients were identified and classified into two groups: 479 patients (43.4%) had a differentiated adenocarcinoma and 624 patients (56.6%) had an undifferentiated adenocarcinoma. Patients with the undifferentiated type were more likely to have large invasive tumors and a higher incidence of peritoneal dissemination. Conversely, the patients with the differentiated type were more likely to have a liver metastasis. Multivariate analysis, using Cox' proportional hazard model adjusted for sex, age, and other factors, suggested that tumor size was one of the seven most independent prognostic factors in patients with the undifferentiated type (relative risk = 1.01), but this parameter lost prognostic value in patients with the differentiated type. With regard to correlation between survival time and tumor size, the larger the tumor (over 10 cm), the shorter the survival time of patients with the undifferentiated type, as compared to findings in patients with the differentiated type (P < 0.01). Thus, differences in clinical characteristics, including characteristics in the individual patients, extent of tumor, distant metastasis, prognostic factors, and prognosis correlate with the histopathological type of gastric carcinoma.
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