Abstract
OBJECTIVE: Gastric cancer, with notable regional variations in incidence rates, ranks as the third most prevalent cause of cancer-related deaths globally and the fifth most common cancer overall. The objective of this study is to examine the pathological, clinical, and demographic characteristics of patients diagnosed with undifferentiated gastric cancer (UGC) and to determine the major prognostic markers that impact survival and recurrence. MATERIALS AND METHODS: This retrospective analysis included patients who underwent surgery for gastric cancer at our center between March 2010 and February 2019. The inclusion criteria required a confirmed diagnosis of UGC and availability of pathological data. Data collected included demographic information, clinical parameters, pathological findings, surgical details, and survival outcomes. The primary outcomes were overall survival and local recurrence. RESULTS: Twenty-four patients were included, 66.7% of whom were male, with a mean age of 58.5 years. Local recurrence occurred in 50% of patients and was significantly associated with perineural and vascular invasion. Receiver operating characteristic (ROC) analysis identified a metastatic lymph node cutoff of 8.5, with an area under the curve (AUC) of 0.826, specificity of 100%, and sensitivity of 63.2%. Patients with fewer than 8.5 metastatic lymph nodes had a median survival of 16.0 months, compared to 7.0 months for those with more than 8.5 nodes (p=0.003). CONCLUSION: Perineural and vascular invasion significantly affect local recurrence in UGC patients. A metastatic lymph node cutoff of 8.5 is a critical predictor of mortality. These findings underscore the importance of thorough pathological assessments and lymph node evaluations in guiding treatment decisions and improving outcomes. Further research is necessary to validate these results and explore additional prognostic markers.