Background: To determine whether there is a specific pattern of clinicopathological features that could be used to distinguish -Borrmann type IV gastric carcinoma from other types of gastric carcinoma.
Methods: We retrospectively analysed the clinicopathological features of patients with Borrmann type IV carcinoma of the stomach. The results were compared with the features of patients who had other types of gastric carcinoma.
Results: The incidence of Borrmann type IV gastric carcinoma was 11.0% (199 patients). A poorly differentiated tumour was found in 120 out of 199 patients (60.3%) with Borrmann type IV gastric carcinoma. The positive lymph node metastasis was found in 150 out of 199 patients (75.4%) with Borrmann type IV gastric carcinoma (P < 0.0001). The incidence of serosal invasion (91.5%) and peritoneal dissemination (37.7%) was significantly higher in these patients. Of the patients with Borrmann type IV gastric carcinoma,161 patients (80.9%) were classified as either stage III or IV at initial diagnosis. The curative resection rate of patients with Borrmann type IV gastric carcinoma was lower than that of patients with other types of gastric carcinoma (P < 0.001). The survival rate was higher in patients with a curative resection(P < 0.001). The 5-year survival rate of patients with Borrmann type IV tumour was lower than that of patients with other types of gastric carcinoma (P < 0.001). The 5-year survival rates were 90.9% for stage I patients with Borrmann type IV gastric carcinoma and 39.5%, 18.6% and 8.7% for stages II, III and IV, respectively (P < 0.001).
Conclusion: Improving the prognosis for patients with Borrmann type IV gastric carcinoma requires early detection and a curative resection.