Clinicopathologic features of submucosal papillary gastric cancer differ from those of other differentiated-type histologies

Seung Yong Shin, Jie Hyun Kim, Myeong Cherl Kook, Do Youn Park, Keun Won Ryu, Il Ju Choi, Sung Hoon Noh, Hyunki Kim, Yong Chan Lee

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Background/Aims: Papillary gastric cancer (GC) is classified as differentiated adenocarcinoma, together with well-differentiated (WD) and moderately differentiated (MD) adenocarcinoma. This study evaluated the risk of lymph node metastasis (LNM) in submucosal (SM) invasive papillary GC compared with other differentiated early GC types. Methods: This retrospective study involved three tertiary hospitals and enrolled 1,798 lesions with differentiated SM invasive GC treated with curative gastrectomy between March 2001 and December 2012. All pathology slides were reviewed, and clinicopathologic findings associated with LNM, including tumor size, location, gross type, ulceration, depth and width of SM invasion, and lymphovascular invasion (LVI), were analyzed. Results: The proportion of SM papillary GC was 2.8% (n=51). SM papillary GC was associated with larger tumor size and deeper and wider SM invasion than other differentiated GC types. LNM was significantly higher in the papillary type than in the MD and WD types. LNM was found in 27.5% of SM papillary GC patients (WD: 9.0%, MD: 21.2%). LVI was the only significant risk factor for LNM in SM papillary GC. The depth or width of SM invasion was not associated with LNM in papillary GC. Lower third location or elevated gross appearance was significantly associated with LVI. Conclusions: SM papillary GC had the highest LNM rate, with features different from those of other differentiated SM invasive GCs. The treatment strategy for SM papillary GC should be carefully approached, especially for lesions located in the lower third or of the elevated gross type.

Original languageEnglish
Pages (from-to)44-52
Number of pages9
JournalGut and liver
Issue number1
Publication statusPublished - 2021

Bibliographical note

Publisher Copyright:
Copyright © Gut and Liver.

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology


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