POSTOPERATIVE RESULTS IN SCIRRHOUS CARCINOMA OF THE STOMACH

概要

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In 530 resected cases of gastric cancer, scirrhous carcinoma occurred in 51 (21 males, 30 females). Operative methods were total gastrectomy in 36 cases and subtotal gastrectomy in 15 cases. Combined resection of adjacent organs was done in 34 cases (66.7%). Most of the cases were classified histologically as poorly differentiated adenocarcinoma. Most of the cases were exposed to the serosa, and most of the cancers were in stage IV. The 4-year-survival rate (y.s.r.) was 9.5%, which is worse than other macroscopic types. The 3-y.s.r. for curative resection cases was 34.4% (n=27) and 5.8% (n=24) for non-curative resection cases, a significant difference (p<0.02). The 3-y.s.r. for tumors 8.0 cm or less was 45.2% (n=15) and 12.8% (n=36) for tumors more than 8.0cm, also a significant difference (p<0.05). The 3-y.s.r. under the classification by Iwanaga was: linitis plastica type, 5.6% (n=18); superficial IIc type, 68.6% (n=8); erosive type, 21.2% (n=18), and stenotic type, 33.3% (n=7, 2-y.s.r.). The survival in the superficial IIc type was significantly better than the linitis plastica type (p<0.02). The methods of adjuvant chemotherapy had no influence on the prognosis. From the above, extended radical operaton of total gastrectomy or combined resection is necessary to improve the prognosis in scirrhous carcinoma.
日本臨床外科学会の論文