Laura Tang, pathologist, Memorial Sloan kettering Cancer Center, New York, USA
Biography
Laura Tang, M.D., Ph.D. is an Attending and Professor of Pathology in the Department of Pathology and Laboratory Medicine at MSKCC and Weill Cornell Medical College. Her clinical practice and research focus on gastrointestinal (GI), pancreas, and liver pathology. She completed her anatomic pathology training at Yale-New Haven Hospital and GI pathology fellowship at MSKCC. Dr. Tang has > 20-years’ experience in clinical practice and routinely handles high volume and complex GI, pancreas, liver cases. She has served as a member of Cancer Committee of College American Pathologist (CAP), member of expert panel to American joint Committee on Cancer (AJCC) 8th Edition Cancer Manual and member of American Society of Clinical Oncology (ASCO) GI Cancer Guideline Advisory Group. Dr. Tang Co-authored the latest edition (Series 4) of Tumor of the Intestines, Armed Force Institute of Pathology (AFIP) Atlas of Tumor Pathology, and contributed articles in 5th and coming 6th Edition of WHO Classification of Tumours in Digestive System.
Summary of presentation
Gastric adenocarcinoma (GAC) is a heterogeneous disease with complex pathogenesis, various anatomical sites, and wide range histopathologic phenotypes. GACs have been classified suing several systems including Laurén and World Health Organization (WHO) classifications, as well as genetic profiling from The Cancer Genome Atlas program (TCGA). In general, most GACs fall into categories as cohesive tubular/intestinal, poorly cohesive (with or without signet ring cells), or a mixed cohesive and poorly cohesive histological subtypes. The phenotypes often correlate to the genetic profiles of the tumors and have important implications for treatment and prognosis. However, there are certain cases where the histological features of GAC do not clearly align with the established classification systems, resulting in what is known as “indeterminate” type. These indeterminate GACs present challenges not only in pathological diagnosis, but also in surgical and oncological management. It is currently unknown whether the genomic profiles and clinical outcome of indeterminate GAC are similar to those of clearly defined cohesive tubular / intestinal or non-cohesive type GACs. Therefore, further investigations that combine detailed pathological assessments and clinical and genetic data are necessary to better characterize these indeterminate subtypes of GAC.