Song Xiao-Hai, Zhang Wei-Han, Chen Xiao-Long, Zhao Lin-Yong, Chen Xin-Zu, Zhou Zong-Guang, Hu Jian-Kun
Department of Gastrointestinal Surgery and Laboratory of Gastric Cancer, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University and Collaborative Innovation Center for Biotherapy, No. 37 Guo Xue Xiang Street, Chengdu, 610041, Sichuan, China.
Department of Gastrointestinal Surgery and Laboratory of Digestive Surgery, Institute of Digestive Surgery and State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center for Biotherapy, No. 37 Guo Xue Xiang Street, Chengdu, 610041, Sichuan, China.
World J Surg Oncol. 2020 Aug 13;18(1):204. doi: 10.1186/s12957-020-01987-5.
Due to the controversy over the prognostic significance of Borrmann type in patients with gastric cancer (GC), the present study was to investigate the clinical value of Borrmann type in advanced GC.
We retrospectively evaluated 2092 patients with advanced GC and subsequently examined the clinicopathological characteristics and prognosis of patients stratified by Borrmann type.
Patients were divided into three groups according to Borrmann type (Borrmann types I+II, III, and IV). Patients with Borrmann types III and IV had larger size, more poorly differentiated tumor type, more advanced tumor stage, and higher chance of involving the entire stomach. The overall survival (OS) rates were significantly different among the three groups (p < 0.001). Stratification analysis revealed significant OS rates among the three groups in tumor-node-metastasis (TNM) stage III (p < 0.001) and TNM stage IV (p = 0.008). Multivariate analysis revealed that Borrmann types, adjuvant chemotherapy, curative resection, and TNM stage were all independent predictors of OS among GC patients. The subgroup analysis indicated that Borrmann type was an independent predictor of OS among GC patients who undergone curative resection and with TNM stage III cancer. However, curative resection and postoperative chemotherapy failed to prolong the survival of patients with Borrmann type IV.
The clinicopathological characteristics and prognosis of patients with three Borrmann types of GC were different. Borrmann type can be simply used as a valuable factor to predict survival in advanced GC patients, especially in those TNM stage III undergoing curative resection. Additionally, more attention should be paid to the treatment for Borrmann type IV GC.
由于胃癌（GC）患者中Borrmann分型的预后意义存在争议，本研究旨在探讨Borrmann分型在晚期GC中的临床价值。
我们回顾性评估了2092例晚期GC患者，随后按Borrmann分型对患者的临床病理特征和预后进行了检查。
根据Borrmann分型（Borrmann I+II型、III型和IV型）将患者分为三组。Borrmann III型和IV型患者的肿瘤体积更大，肿瘤分化程度更低，肿瘤分期更晚，累及全胃的几率更高。三组患者的总生存期（OS）率有显著差异（p<0.001）。分层分析显示，在肿瘤-淋巴结-转移（TNM）III期（p<0.001）和TNM IV期（p = 0.008）的三组患者中，OS率有显著差异。多因素分析显示，Borrmann分型、辅助化疗、根治性切除和TNM分期均为GC患者OS的独立预测因素。亚组分析表明，Borrmann分型是接受根治性切除且TNM分期为III期的GC患者OS的独立预测因素。然而，根治性切除和术后化疗未能延长Borrmann IV型患者的生存期。
三种Borrmann分型的GC患者的临床病理特征和预后不同。Borrmann分型可简单用作预测晚期GC患者生存的有价值因素，尤其是那些TNM分期为III期且接受根治性切除的患者。此外，应更加关注Borrmann IV型GC的治疗。
