Pathological characteristics of gastric carcinomas in the very old

A total of 69 gastric carcinomas of very old people (aged greater than or e qual to 85) were collected and pathologically analyzed in comparison with t hose of young to middle-aged (30-39) and elderly (65-69) people, with speci al attention to their phase. In the very old, almost all (34/35) carcinomas in the early phase belonged to well-differentiated categories. In the adva nced phase, half of them (17/34) were classified into poorly differentiated categories when determined from the predominant pattern, but a well-differ entiated pattern almost always coexisted in the superficial site, Thus, the gastric carcinomas in the very old may principally develop as well-differe ntiated carcinomas which then progress to poorly differentiated carcinomas with time, in contrast to those of the young to middle-aged, most of which emerged from the very early phase as poorly differentiated lesions, The gro ss features of the carcinomas were also in line with these histological obs ervations, The carcinomas of the elderly showed distinct similarity to thos e of the very old. The results suggest that poorly differentiated carcinoma s of the young to middle-aged and the old may be better classified and anal yzed separately in view of the generally recognized etiological (e.g., spec ifically close causal relationship with environmental factors of the intest inal-type carcinoma of the old) and biological (e.g., practically no tenden cy for hematogenous metastasis of the diffuse-type carcinoma of the young t o middle-aged) differences, although in the General Rules for Gastric Cance r Study of Japan, both are placed in the same category, por (por2).