Highlights
- •The Laurén classification is prognostic for survival in oesophagogastric cancer.
- •Intestinal type tumours are associated with a better survival.
- •Survival of oesophageal adenocarcinoma improved over the years.
- •Survival of diffuse type gastric carcinoma remained relatively unchanged.
Abstract
Aim
To investigate the nationwide time trends in incidence and survival of oesophageal
and gastric adenocarcinomas according to the Laurén classification (intestinal, diffuse
and mixed type).
Methods
All patients diagnosed in the Netherlands with oesophageal or gastric adenocarcinoma
between 1989 and 2015 were included. A syntax was developed to determine the histological
subtype based on pathology reports as archived in the Dutch pathology registry. These
reports were linked to individual data from the Netherlands Cancer Registry. Relative
survival was used to assess survival.
Results
The histological subtype could be determined in 18.691 (84.1%) oesophageal and in
32.312 (83.5%) gastric adenocarcinomas. Among these, 79% were intestinal and 21% diffuse
type in oesophageal cancers, compared to 55% intestinal and 44% diffuse type in gastric
cancers. Relative median survival of intestinal type tumours was longer than that
of diffuse type tumours, that is, 12.1 versus 9.4 months for oesophageal carcinomas,
and 10.1 versus 7.6 months for gastric carcinomas, respectively. Between 1989 and
2015, the relative median survival of non-metastatic intestinal and diffuse type oesophageal
adenocarcinoma improved from 12.0 to 30.0 months, and from 12.0 to 19.2 months, respectively.
The same was true for intestinal type gastric carcinoma (from 22.8 to 27.6 months)
but for diffuse type gastric carcinoma, the increase was less (from 16.8 to 18.0 months).
Conclusion
In this nationwide study, histological subtypes of oesophageal and gastric adenocarcinomas
differed in incidence and survival times. These findings may call for a differentiated
treatment approach.
Keywords
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References
- (Available from:) ([cited 2018 May 15]. n.d)
- Increased incidence and survival for oesophageal cancer but not for gastric cardia cancer in The Netherlands.Eur J Canc. 2012; 48: 1624-1632
- Gastric cancer: decreasing incidence but stable survival in The Netherlands.Acta Oncol (Madr). 2014; 53: 138-142https://doi.org/10.3109/0284186X.2013.789139
- Preoperative chemoradiotherapy for esophageal or junctional cancer.N Engl J Med. 2012; 366: 2074-2084
- Chemotherapy versus chemoradiotherapy after surgery and preoperative chemotherapy for resectable gastric cancer (CRITICS): an international, open-label, randomised phase 3 trial.Lancet Oncol. 2018; 19: 616-628https://doi.org/10.1016/S1470-2045(18)30132-3
- Differences in outcomes of oesophageal and gastric cancer surgery across Europe.Br J Surg. 2013; 100: 83-94
- Long-term survival improvement in oesophageal cancer in The Netherlands.Eur J Canc. 2018; 94: 138-147https://doi.org/10.1016/j.ejca.2018.02.025
- The prognostic and potentially predictive value of the Laurén classification in oesophageal adenocarcinoma.Eur J Canc. 2017; 76: 27-35
- The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma.Acta Pathol Microbiol Scand. 1965; 64: 31-49
- Bosman F.T. Carneiro F. Hruban R.H. Theise N.D. WHO classification of tumours of the digestive system. IARC, Lyon2010 (n.d)
- Stomach carcinoma incidence patterns in the United States by histologic type and anatomic site.Cancer Epidemiol Biomarkers Prev. 2009; 18: 1945-1952
- Epidemiology and risk factors for oesophageal adenocarcinoma.Dig Liver Dis. 2013; 45: 625-629https://doi.org/10.1016/j.dld.2012.12.020
- Changing trends in stomach cancer throughout the world.Curr Gastroenterol Rep. 2017; 19: 36-37https://doi.org/10.1007/s11894-017-0575-8
- International classification of diseases for Oncology.3rd ed., 1st revision. World Health Organization, Geneva2013
- Sobin L. Wittekind C. TNM classification of malignant tumours. 6th ed. John Wiley&Sons Ltd., New York2002
- On estimation in relative survival.Biometrics. 2012; 68: 113-120https://doi.org/10.1111/j.1541-0420.2011.01640.x
- Time trend analysis of gastric cancer incidence in Japan by histological types, 1975-1989.Br J Canc. 2001; 84: 400-405https://doi.org/10.1054/bjoc.2000.1602
- Oesophageal and gastric intestinal-type adenocarcinomas show the same male predominance due to a 17 year delayed development in females.Gut. 2009; 58: 16-23
- Oesophageal adenocaricnoma and gastric cancer: should we mind the gap?.Nat Rev Canc. 2016; 16: 305-318
- A model for gastric cancer epidemiology.Lancet. 1975; 2: 58-60
- Hereditary diffuse gastric cancer syndrome: CDH1 mutations and beyond.JAMA Oncol. 2015; 1: 23-32https://doi.org/10.1001/jamaoncol.2014.168
- Comparison of gene-expression profiles between diffuse- and intestinal-type gastric cancers using a genome-wide cDNA microarray.Oncogene. 2004; 23: 6830-6844https://doi.org/10.1038/sj.onc.1207886
- Comprehensive molecular characterization of gastric adenocarcinoma.Nature. 2014; 513: 202-209
- Phase III trial comparing capecitabine plus cisplatin versus capecitabine plus cisplatin with concurrent capecitabine radiotherapy in completely resected gastric cancer with D2 lymph node dissection: the ARTIST trial.J Clin Oncol. 2012; 30: 268-273https://doi.org/10.1200/JCO.2011.39.1953
- Gastrectomy plus chemotherapy versus chemotherapy alone for advanced gastric cancer with a single non-curable factor (REGATTA): a phase 3, randomised controlled trial.Lancet Oncol. 2016; 17: 309-318
- Pathohistological classification systems in gastric cancer: diagnostic relevance and prognostic value.World J Gastroenterol. 2014; 20: 5679-5684
- Surgical treatment results of intestinal and diffuse type gastric cancer. Implications for a differentiated therapeutic approach?.Eur J Surg Oncol. 2013; 39: 686-693
- Recent trends and predictors of multimodality treatment for oesophageal, oesophagogastric junction, and gastric cancer.Acta Oncol (Madr). 2015; 54: 1754-1762
- Quality of care indicators for the surgical treatment of gastric cancer: a systematic review.Ann Surg Oncol. 2013; 20: 381-398https://doi.org/10.1245/s10434-012-2574-1
- Surgical treatment of gastric cancer: 15-year follow-up results of the randomised nationwide Dutch D1D2 trial.Lancet Oncol. 2010; 11: 439-449https://doi.org/10.1016/S1470-2045(10)70070-X
- Integrated genomic characterization of oesophageal carcinoma.Nature. 2017; 541: 169-175https://doi.org/10.1038/nature20805
- Distinct molecular subtypes of gastric cancer: from Laurén to molecular pathology.Oncotarget. 2018; 9: 19427-19442https://doi.org/10.18632/oncotarget.24827
- The impact of perioperative chemotherapy on survival in patients with gastric signet ring cell adenocarcinoma: a multicenter comparative study.Ann Surg. 2011; 254: 684-693https://doi.org/10.1097/SLA.0b013e3182352647
- Histopathological regression predicts treatment outcome in locally advanced esophagogastric adenocarcinoma.Eur J Canc. 2018; 90: 26-33https://doi.org/10.1016/j.ejca.2017.11.020
Article info
Publication history
Published online: March 11, 2020
Accepted:
February 4,
2020
Received:
January 14,
2020
Identification
Copyright
© 2020 Elsevier Ltd. All rights reserved.
