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Total gastrectomy for gastric cancer. Clinical considerations on 431 cases
Author(s) -
Fujimaki Masao,
Soga Jun,
Wada Kanji,
Tani Hisashi,
Aizawa Osamu,
Kawaguchi Masaki,
Ishibashi Kiyoshi,
Maeda Masakatsu,
Kanai Tomoyuki,
Omori Yukio,
Muto Terukazu
Publication year - 1972
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197209)30:3<660::aid-cncr2820300313>3.0.co;2-4
Subject(s) - medicine , gastrectomy , lymph , lymph node , stomach , cancer , splenectomy , lymph node metastasis , metastasis , splenic artery , pathology , radiology , surgery , spleen
On the basis of the invasive and metastatic natures of gastric cancer, 431 cases of total gastrectomy were analyzed from the standpoint of surgical treatments. Histologic scrutinization showed that 83% of the cases (199/241) had lymph node metastasis, and 26% of the lymph nodes (2,226/8,698) were involved. In cancer of the upper stomach, lymph node involvement became suddenly widespread in extent and high in rate, both for the cases and for the lymph nodes with the serosal invasion by the primary lesions. In addition, a serial sectioning technique from the splenic hilus through the splenic artery region disclosed that latent lymph node metastasis evident only on histologic scrutinization consisted of 62% of the involved lymph nodes. These rather unexpected results suggest that, in most cases with advanced cancer in the upper stomach or of a diffuse form, a total gastrectomy combined with a splenectomy and caudal hemipancreatectomy would be a necessary surgical procedure.