Factors Influencing the Postoperative Long-term Results of the Patients with Gastric Cancer Spreading into the Subserosal Layer

Hiroshi Habu, Masashi Kono, Masao Tani, Toru Honda, Fumio Kondo, Michio Maruyama, Kimiya Takeshita, Masakatsu Sunagawa, Mitsuo Endo

First Department of Surgery, Tokyo Medical and Dental University School of Medicine

Long-term results were studied in 141 patients who had undergone gastrectomies for gastric cancer invading up to the subserosal layer. The 5-year survival rate for the patients as a whole was 49.1%, while it was significantly lower in the patients who had undergone non-curative resections (15.8%), removal of lymph nodes R₁ (18.8%) or R₃ (36.1%), those with cancer of macroscopic type 4 (6.5%), a cancer larger than 10 cm (31.2%), P (+) (18.2%) H (+) (20.0%), microscopically undifferentiated type (39.8%), lymph node metastasis of n₂ (29.0%) or n₃ (25.0%), stage III (29.5%) or IV (16.4%), lymph vessel invasion of ly₃ (28.2%), and a growth pattern of INFγ (41.8%). The patients in whom the length of cancer infiltration in the subserosal layer was 5 cm or more showed a lower 5-year survival rate (19.8%) than those in whom the length was 4 cm or less (56.1%) (p<0.001). A significant difference was noted between these two groups regarding the 5-year survival rates after the curative resections, 24.8% and 64.1%, respectively (p<0.01). In regard to the mode of recurrence after the curative resections, hematogenous metastasis was characteristic (71.4%) of the latter group, while in the former group, peritoneal disseminating metastasis was the most frequent mode (71.4%) and it seemed to be the main cause of the poor outcome in this group.

Key words
gastric cancer with subserosal invasion, postoperative prognostic factors, size of subserosal invasion, survival rate, recurrence with peritoneal dissemination

Reprint requests
Hiroshi Habu First Department of Surgery, Tokyo Medical and Dental University, School of Medicine
1-54-5 Yushima, Bunkyo-ku, Tokyo, 113 JAPAN

Accepted
April 11, 1990

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