Accurate prognostic value of morphovolumetric analysis of advanced carcinoma of the stomach.

Two hundred and seventy-five patients with advanced carcinoma of the stomach invading the serosa were morphovolumetrically classified into three types: funnel, column and mountain. The funnel type, in which cancer cells narrowly invaded the deep wall compared with the extent of spread in the mucosa, was associated with less frequent metastases and a better prognosis (five year survival rate of 49 per cent). The column type, in which cancer cells invaded the deep wall as wide as the mucosa, and the mountain type, in which cancer cells widely invaded the deep wall, were associated with high frequent metastases and a poor prognosis (five year survival rates of 17 and 13 per cent, respectively). Division was also made into expanding and infiltrative types. In patients with the column type, those with infiltrative type had a poorer outcome than did those with the expanding type, while patients with the funnel type had a better prognosis than those with the other two types, regardless of the infiltration and expansion. The expanding type had a propensity for metastases to the liver and infiltrative type for peritoneal seeding. Combination of these classifications provides a prognostic evaluation and assessment of the behavior of advanced carcinoma of the stomach.