Prognostic evaluation of dirty necrosis and tumor necrosis in gastric cancers

Abstract This study examines the prognostic significance of tumor necrosis and dirty necrosis in gastric cancer. Tumor necrosis, often linked to rapid tumor growth and insufficient vascularization, is a known poor prognostic indicator in several cancer types. Dirty necrosis, a special form seen with neutrophils and necrotic debris, has prognostic value in cancers like colorectal carcinoma and renal cell carcinoma. The presence of tumor-associated neutrophils (TANs) and NETosis, a process where neutrophils release extracellular traps, also plays a role in tumor progression and prognosis.This study included 187 gastric cancer patients who underwent surgery at Eskisehir Osmangazi University.Dirty necrosis was present in 39.6% of cases, with significant associations found between dirty necrosis and tumor type, grade, lymph node stage, and TIL presence. The study demonstrated that dirty necrosis correlated with longer recurrence-free survival and overall survival. Additionally, patients with dirty necrosis and prominent TILs exhibited improved survival outcomes.The findings suggest that dirty necrosis, particularly when associated with TIL, may indicate a better prognosis in gastric cancer. This study highlights the importance of re-evaluating necrosis types in gastric cancer prognosis and treatment strategies.