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Noncurative resection for advanced gastric cancer
Author(s) -
Maehara Yoshihiko,
Kakeji Yoshihiro,
Takahashi Ikuo,
Okuyama Toshiro,
Baba Hideo,
Anai Hideaki,
Sugimachi Keizo
Publication year - 1992
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.2930510404
Subject(s) - medicine , metastasis , cancer , distant metastasis , surgery , lymphovascular invasion , lymph , chemotherapy , oncology , pathology
Abstract Between 1965 and 1985, 489 patients with advanced gastric cancer who were treated with gastric resection and in whom tumor cells remained after the operation were defined as cases of a “noncurative resection.” The clinicopathological features and prognosis of these patients were examined and two groups were prepared: locally advanced cancer and cancer with a distant metastasis. In locally advanced cancer cases, tumor cells remained in the neighboring organs, lymph nodes, and/or resected margins; in those with distant metastasis, peritoneal dissemination and/or liver metastasis were present regardless of whether or not the metastasis was removed, with or without locally noncurative factors. Serosal invasion was prominent and high rates of lymph node metastasis and lymphatic inolvement were evident in both groups. The survival rate for patients with locally advanced gastric cancer was better than that of patients with distant metastasis ( P < 0.01). Survival time in patients with locally advanced cancer can be lengthened by resecting all of the primary tumor and as much of the metastatic lesions as possible, even if the surgical management is “noncurative.” Aggressive postoperative chemotherapy for patients with distant metastasis from a gastric cancer is to be recommended. © 1992 Wiley‐Liss, Inc.