Abstract
Among 1,220 Japanese patients with gastric carcinoma who had undergone resection in the Department of Surgery II, Kyushu University Hospital, Fukuoka, Japan from 1965 to 1980, there were 432 (35.4%) with far advanced carcinoma, designated as a lesion with factors such as peritoneal dissemination, hepatic metastasis, widespread nodal involvement extending to tertiary (hepatoduodenal, retropancreatic, and mesenteric) or quaternary (middle colic and paraaortic) nodes, or direct invasion to adjacent organs. The overall 5-year survival rate in these 432 patients was 10.2%. The 5-year survival rate in patients with a single factor was 16.3%, being significantly higher than the 2.8% or less in cases with more than 2 factors ( p<0.01). Patients with tertiary nodal involvement or directly invaded organs alone survived at a rate of 26.1% and 21.8% in the 5-year follow-up, respectively. Radical procedures such as extensive lymphadenectomy and combined resection of the invaded organs further lengthened the survival time. The 5-year survival rates were less than 10% in patients with other factors, singly or more than 2 factors in combination. There appear to be 2 subgroups in whom the rates of survival differ: potentially curable and noncurable patients. More intensive therapeutic regimens corresponding to both groups need to be considered.
Résumé
Parmi 1,220 japonais atteints de cancer de l'estomac qui ont subi une résection dans le Département de Chirurgie II de l'hÔpital Universitaire Kyushu, Fukuoka, Japan de 1965 à 1980, 432 (35.4%) présentaient des lésions avancées qu'il s'agisse de dissémination péritonéale, de métastases hépatiques, d'une extension ganglionnaire importante intéressant les groupes tertiaires (hépatoduodénal, rétro-pancréatique, et mésentérique) ou quaternaires (coliques moyens et paraaortiques) ou encore l'invasion directe d'organes voisins. Le taux de survie totale à 5 ans de ces 432 malades a été de 10.2%. Ce taux a été de 16.3% en présence d'un seul des facteurs et 2.8% ou moins en présence de plus de 2 facteurs (p<0.01). Le taux de survie à 5 ans fut respectivement de 26.1% et de 21.8% selon qu'existait un envahissement ganglionnaire tertiaire ou l'invasion isolée d'un organe voisin. Les techniques radicales: lymphadénectomie élargie et résection combinée des organes envahis sont suivies d'un allongement du temps de survie. Les taux de survie à 5 ans furent inférieurs à 10% chez les malades atteints d'autres facteurs isolés ou supérieurs à deux. Il apparaÎt ainsi que dans le cancer de l'estomac deux sous-groupes, dont le temps de survie est différent, sont à distinguer: les malades potentiellement curables et les malades incurables. Il est donc nécessaire de mettre au point des méthodes thérapeutiques efficaces en fonction des 2 groupes individualisés.
Resumen
Entre 1,220 pacientes japoneses con carcinoma gástrico sometidos a resección en el Departamento de Cirugía II, Hospital de la Universidad de Kyushu, Fukuoka, Japan entre 1965 y 1980, hubo 432 (35.4%) con carcinoma avanzado, entendiéndose como tal una lesión con hallazgos tales como diseminación peritoneal, metástasis hepáticas, extensión ganglionar amplia hasta los ganglios terciarios (hepatoduodenales, retropancreáticos, y mesentéricos) o cuaternarios (cólicos medios y paraaórticos), o invasión directa de órganos adyacentes. La tasa global de supervivencia a 5 años en estos 432 pacientes fue 10.2%. La tasa de supervivencia a 5 a~nos en pacientes con uno solo de tales hallazgos fue 16.3%, que es significativamente mayor que la de 2.8% o menos en pacientes con más de 2 de tales hallazgos (p<0.01). Los pacientes con invasión ganglionar terciaria o con invasión directa de órganos solamente, sobrevivieron a una tasa de 26.1% y 21.8%, respectivamente, en el seguimiento a 5 años. Procedimientos radicales tales como la linfadenectomía amplia y la resección combinada de los órganos afectados resultó en prolongación del periodo de supervivencia. Las tasas de supervivencia a 5 años fueron menores de 10% en pacientes con otros hallazgos en combinaciones Únicas o de más de 2. Parece haber 2 subgrupos en quienes las tasas de supervivencia difieren: los pacientes potencialmente curables y los no curables. Regimenes terapéuticos correspondientes a los 2 grupos deben ser considerados.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Ribeiro, M.M., Sobrinho SimÕes, M.A., Bastos, J.: Analysis of 242 cases of gastric carcinoma. World J. Surg.5:97, 1981
Buchholtz, T.W., Welch, C.E., Malt, R.A.: Clinical correlates of resectability and survival in gastric carcinoma. Ann. Surg.188:711, 1978
Ekbom, G.A., Gleysteen, J.J.: Gastric malignancy. Resection for palliation. Surgery88:476, 1980
Miwa, K.: Cancer of the stomach in Japan. In Gann Monograph, No. 22, Recent Results of Cancer Treatment in Japan, T. Kajitani, T. Koyama, T. Umegaki, editors, Tokyo, Japan Scientific Societies Press, 1979, pp. 61–75
Yamada, E., Miyaishi, S., Nakazato, H., Kato, K., Kito, T., Takagi, H., Yasue, M., Kato, T., Morimoto, T., Yamauchi, M.: The surgical treatment of cancer of the stomach. Int. Surg.65:387, 1980
Japanese Research Society for Gastric Cancer: The general rules for the gastric cancer study in surgery and pathology. Jpn. J. Surg.11:127, 1981
Soga, J., Kobayashi, K., Saito, J., Fujimaki, M., Muto, T.: The role of lymphadenectomy in curative surgery for gastric cancer. World J. Surg.3:701, 1979
Kodama, Y., Sugimachi, K., Soejima, K., Matsusaka, T., Inokuchi, K.: Evaluation of extensive lymph node dissection for carcinoma of the stomach. World J. Surg.5:241, 1981
Benedetti, J., Yuen, K., Young, L.: Life tables and survival functions 1L. In BMDP Statistical Software, W.J. Dixon, editor, Berkeley, University of California Press, 1985, pp. 557–575
Diggory, R.T., Cuschieri, A.: R2/3 gastrectomy for gastric carcinoma: An audited experience of a consecutive series. Br. J. Surg.72:146, 1985
Inokuchi, K., Hattori, T., Taguchi, T., Abe, O., Ogawa, N.: Postoperative adjuvant chemotherapy for gastric carcinoma. Analysis of data on 1805 patients followed for 5 years. Cancer53:2393, 1984
Shiu, M.H., Papacristou, D.N., Kosloff, C., Eliopoulos, G.: Selection of operative procedure for adenocarcinoma of the midstomach. Ann. Surg.192:730, 1980
Kishimoto, H., Koga, S.: Evaluation of gastrectomy combined with the resection of other organs in the treatment of gastric cancer. Jpn. J. Surg.9:173, 1979
Koga, S., Maeta, M., Shimizu, N., Osaki, Y., Hamazoe, R., Oda, M., Karino, T., Yamane, T.: Clinical effects of total-body hyperthermia combined with anticancer chemotherapy for far-advanced gastrointestinal cancer. Cancer55:1641, 1985
Koga, S., Kawaguchi, H., Kishimoto, H., Tanaka, K., Miyano, Y., Kimura, O., Takeda, R., Nishidoi, H.: Therapeutic significance of noncurative gastrectomy for gastric cancer with liver metastasis. Am. J. Surg.140:356, 1980
Kaibara, N., Okamoto, T., Kimura, O., Iitsuka, Y., Takebayashi, M., Yurugi, E., Nishidoi, H., Tamura, H., Koga, S.: Possible role of lymph node dissection in the surgical treatment of gastric cancer with disseminating peritoneal metastasis. Jpn. J. Surg.13:404, 1983
Takagi, K., Ohashi, I., Kajitani, T.: Left upper abdominal evisceration for advanced cancer of the stomach. Surg. Ther.52:416, 1985
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Korenaga, D., Tsujitani, S., Haraguchi, M. et al. Long-term survival in Japanese patients with far advanced carcinoma of the stomach. World J. Surg. 12, 236–239 (1988). https://doi.org/10.1007/BF01658063
Issue Date:
DOI: https://doi.org/10.1007/BF01658063