Classification of gastric carcinoma using the Goseki system provides prognostic information additional to TNM staging

Ilfet Songun, Cornelis J H Van De Velde, Jan W. Arends, Paul Blok, A. Joris K Grond, G. Johan A Offerhaus, Jo Hermans, Joannes H J M Van Krieken

Research output: Contribution to journalArticlepeer-review

36 Scopus citations


BACKGROUND. Due to the high variability of the epidemiology, genetics, morphology, and biologic behavior of gastric carcinoma, many classification systems are in use, e.g., the World Health Organization (WHO) classification; tumor differentiation; the criteria of Ming, Mulligan, and Lauren; and the recently introduced Goseki classification. In the authors' opinion, the TNM staging is the most valuable classification system, with a prognostic value for survival. METHODS. To assess the reproducibility and usefulness of these systems in clinical practice, material from 285 gastric carcinoma patients entered in the Dutch Gastric Cancer Trial was analyzed by a panel of 5 experienced gastrointestinal pathologists. The presence of eosinophilic and lymphocytic infiltrates was analyzed in addition to the TNM staging. RESULTS. Of the analyzed classification systems, only TNM stage, tumor differentiation, eosinophilic infiltrate, and the Goseki system contained information associated with the survival of patients with gastric carcinoma. The reproducibility was perfect for tumor differentiation (Kappa 1.00), nearly perfect for the WHO and Goseki classifications (Kappa 0.86 and 0.87, respectively), reasonably good for Lauren and lymphocytic infiltrate (Kappa 0.70), and reasonably good for eosinophilic infiltrate (Kappa 0.42). CONCLUSIONS. Of all these systems, the Goseki classification was the only system with prognostic value that is additional to TNM staging.

Original languageEnglish (US)
Pages (from-to)2114-2118
Number of pages5
Issue number10
StatePublished - May 15 1999
Externally publishedYes


  • Classification systems
  • Gastric carcinoma
  • Prognostic value
  • Reproducibility

ASJC Scopus subject areas

  • Cancer Research
  • Oncology


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