Gastric cancer: prognostic significance of the Goseki histological classification

Gastric cancer: prognostic significance of the Goseki histological classification. B. Sciiletta, R. Lanteri, C. Rapisarda, L Greco, S. Lanzafame, A. Torrisi, S. Puleo, A. Licata. The aim of this study was to evaluate the prognostic significance of the Goseki factor in patients undergoing potentially curative resection for gastric cancer. From 1989 to 1999 202 patients with gastric cancer carne in for observation to the 1st Surgical Clinic of Catania University. For the purposes of this study we examined 86 patients with a 5-year follow- up, from whom it was possible to obtain samples which were mounted in paraffin blocks and stained (haematoxylin-eosin and PAS-Aician blue). The 5-year survival rates of patients with Goseki l and Il tumours with good tubular differentiation were 90% and 30o/o as compared with 42°/o and 32% in patients with tumours that showed poor tubular differentiation (Goseki III and IV). In contrast the 5-year survival rates in patients with mucin-poor tumours (Goseki l and 111) were 90% and 42o/o, as against 30% and 32% in patients with mucin-rich tumours (P<O.OS). Our conclusion is that of the two components of the Goseki system, i.e. tubular differentiation and intracellular mucus, mucus production was found to be the more important determinant of clinica! outcome. Mucus production has a greater impact on survival than the degree of tubular differentiation and is i ndependent of i t.