Clinicopathological Study of Peritoneal Dissemination in the Gastric Cancer

Takashi Fujimura, Yutaka Yonemura, Toru Kamata, Shigeru Takegawa, Shigekazu Oyama, Kazuo Sugiyama, Hajime Hasegawa, Takeo Kosaka, Koichi Miwa, Itsuo Miyazaki

The Second Department of Surgery, School of Medicine, Kanazawa University

Our strategy for peritoneal dissemination (PD) in gastric cancer has been the elaborate resection of the tumors and continuous hyperthermic peritoneal perfusion (CHPP). In 58 patients (primary, n=40; recurrent, n=18) with gastric cancers with PD the cancers were grouped into tubercular (TB), nodular (ND), diffuse (DF), and unclassified type by gross findings. The predominant characteristics of the patients with PD were Borrmann types 3 and 4 (84%) in gross findings, poorly adenocarcinoma (71%) in histological finding, under ssγ (96%) in depth, scirrhous (71%) in stroma, INFγ (82%) in infiltrative growth, ly₂ + ly₂ (70%) in lymphatic invasion, and v₀ + v₁ (94%) in venous invasion. In the recurrence group there were more TB and DF types than in the primary group (p<0.05). There was no significant difference in survival times between the primary and the recurrence groups or between types of PD. The survival time of the resected group was significantly longer than that of the non-resectd group (p<0.01). The survival time of the CHPP (+) goup was significantly longer than that of CHPP (-) group (p<0.05). In the TB and ND types the outcome in the resected and CHPP (+) groups was better than in the non-resected and CHPP (-) groups. Resection of the tumor and CHPP have a chance of improving the patients with gastric cancer with PD, especially of the TB and ND types.

Key words
classification of gross findings in peritoneal dissemination from gastric cancer, continuous hyper-thermic peritoneal perfusion, prognosis of the gastric cancer with peritoneal dissemination

Reprint requests
Takashi Fukimura Department of Surgery, Takaoka City Hospital
4-1 Takaramachi, Takaoka, 933 JAPAN

Accepted
March 7, 1990

To read the PDF file you will need Abobe Reader installed on your computer.