AUTHOR=Han Yang , Xuan Yi , Liu Xiaowen , Zhu Hui , Zhang Meng , Xu Dazhi , Wang Yanong , Cai Hong 

TITLE=Development of a Quantitative Diagnostic Criterion for Gastric Linitis Plastica: Findings From a Large Single-Institutional Study

JOURNAL=Frontiers in Oncology

VOLUME=Volume 11 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2021.683608

DOI=10.3389/fonc.2021.683608

ISSN=2234-943X

ABSTRACT=Gastric linitis plastica (GLP) is a descriptive term but lacks a quantitative definition. Several relatively quantitative criteria had been proposed, such as tumor involving a limit of 1/3 or 2/3 of the gastric surface. However, these criteria needed doctors to subjectively judge tumor infiltration area, which made diagnosis difficult to be objective and reproducible. This study aimed to propose a quantitative diagnostic criterion for distinguishing GLP. We performed a retrospective cohort study of 2907 patients with Bormann III and IV gastric cancer (GC) who underwent gastrectomy between 2011 and 2018 in our center. The Kaplan-Meier curves showed that patients with observed tumor size more than 8cm had obviously lower overall survival (OS) and disease-free survival (DFS) rates than those with size less than 8cm(P<0.001; P<0.001). However, there was no significantly different prognosis of patients with tumor size between more than 8cm and more than 10cm (P=0.248; P=0.534). Moreover, patients with tumor size greater than 8cm more presented with advanced stage and had extremely poor 3-year OS and DFS (31.4%;29.3%), with a stronger propensity towards peritoneal metastasis. Therefore, we considered patients’ observed tumor size more than 8cm as a critical value for distinguishing the prognosis of Bormann III and IV GC. Furthermore, we proposed observed tumor size more than 8cm as a quantitative diagnostic criterion for GLP on the premise of satisfaction originally descriptive and pathological definition regardless of Bormann type.