Prognostic factors in stomach cancer surgery.

The most important tumour-related prognostic factors in gastric carcinoma are the depth of infiltration and lymphatic spread. The tumour site itself did not significantly influence prognosis. Histological type according to the WHO classification as well as the histological degree of malignancy were of no significance. Lauréns classification offers no great prognostic difference for tumours within the same stage, but at the time of diagnosis, diffuse type generally shows a more advanced stage than intestinal type. Prognosis is decisively influenced by the choice of surgical therapy, especially by whether the tumour can be curatively removed or not, and by the margins of clearance obtained in curative surgery. The extent of these margins of clearance should be chosen bearing in mind the differences between growth behaviour of intestinal and diffuse type carcinomas. In this fashion, a histology-oriented surgical approach can be achieved.