Prognostic value of depth and pattern of stomach wall invasion in patients with an advanced gastric carcinoma.

We reviewed data on 467 patients with advanced gastric carcinoma, taking into consideration tumor size, shape and depth of invasion, and growth pattern, either expanding or infiltrative. Three patterns of penetration were identified: i.e., funnel, column, and mountain patterns. The funnel pattern was predominant in tumors extending into the muscularis propria (pm) or subserosa (ss), and were more widely distributed than the column pattern. The majority of the column type tumors were less than 8 cm in pm or ss, and the mountain type was found in only one case in ss, but their size was widely distributed once cancer cells penetrated the serosa. Patients with the funnel type had a better prognosis than the column or the mountain type, and the difference was significant when cancer invasion extended to the serosa.