Indication of Pancreatosplenectomy for Gastric Cancer on the Upper Part of the Stomach

Toru Kamata, Yutaka Yonemura, Shigekazu Ooyama, Shigeru Takegawa, Hironobu Kimura, Hisashi Matsumoto, Koichirou Tsugawa, Takeo Kosaka, Koichi Miwa, Itsuo Miyazaki

Department of Surgery II, School of Medicine, Kanazawa University

In order to establish the indication for pancreatosplenectomy for gastric cancer in the upper portion of the stomach,228 patients were studied. The rate of metastasis to No. 10 and No. 11 lymph nodes (LN) was 13% and 18%,respectively. In the patients with No. 10 or No. 11 LN metastasis, the rate of metastasis to No. 3 LN was 70%, and about 50%, to No. 1, 2 and 7. Although metastasis to No. 10 and No. 11 LN was not found in early gastric cancers, metastasis to those nodes was investigated in patients with gastrc cancers invading to the propria mucosa and the rate increased according to the degree of depth of invasion. Even in the cases without gross serosal invasion, the rate of metastasis to No. 10 and No. 11 was 2.4% and 7.l%, respectively. In case of advanced gastric cancer, the outcome for patients with pancreatosplenectomy was significantly better than that for patients without it. In contrast, in early gastric cancer, no significant difference was found in the outcome in the two groups. Therefore, pancreatosplenectomy must be carried out in advanced gastric cancer.

Key words
upper gastric cancer, pancreatosplenectomy

Reprint requests
Toru Kamata Department of Surgery II, School of Medicine, Kanazawa University
13-1 Takara-machi, Kanazawa, 920 JAPAN

Accepted
October 11, 1989

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