Sequential Methotrexate and 5-Fluorouracil Therapy for Borrmann Type 4 Gastric Cancer as One of the Multidisciplinary Therapy

Masatsugu Kitamura, Kuniyoshi Arai, Kaoru Miyashita

Department of Surgery, Tokyo Metropolitan Komagome Hospital

The efficacy of sequential methotrexate·5FU (MTX·5FU) treatment for Borrmann type 4 gastric cancer was evaluated. Of 279 Borrmann type 4 gastric cancer cases, 250 surgical cases were analyzed as subjects for the present study. Subjects were classified as follows: 54 unresectable cases (21.6%), 196 resectable cases (78.4%), including 8l curative cases, and 115 non-curative cases. Although in curative cases MTX·5FU treatment resulted in better prognosis than other treatments using adriamycin·5FU, mitomycin C·5FU, and pyrimidine fluoride, the differences were not significant. In contrast, in the non-curative cases, the MTX·5FU group showed a significantly better prognosis than the other chemotherapy groups (p<0.05). In the unresectable cases undergoing chemo therapy, the prognosis of the MTX·5FU group was significantly better than that of the other chemotherapy groups (p<0.01). Multidisciplinary therapy might be necessary for Borrmann type 4 gastric cancer, owing to the limitations of the surgical procedures. Therefore, sequential MTX·5FU treatment is considered to be a useful therapy for this type of gastric cancer.

Key words
Borrmann type 4 gastric cancer, biochemical modulation, sequential methotrexate·5FU therapy, multidisciplinary therapy

Reprint requests
Masatsugu Kitamura Department of Surgery, Tokyo Metropolitan Komagome Hospital
3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113 JAPAN

Accepted
September 4, 1991

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