Clinicopathological Studies and Therapeutic Results on the Duodenal Extension of the Gastric Cancer Located in the Lower Portion

Toshitaka Takehana, Toshio Imada, Kimiatsu Hasuo, Yasushi Rino, Akira Tsuburaya, Yoshikazu Noguchi, Yuji Yamamoto, Tomishige Amano, Akihiko Matsumoto

First Department of Surgery, Yokohama City University School of Medicine

To determine the relationship between the pyloric ring and the degree of advancement and the prognosis of gastric cancer, 162 cases of gastric cancer located in the lower portion were studied. Cancers which were adjacent to the pyloric ring or extended across the pyloric ring to the duodenum (the pyloric ring group) were compared clinicopathologically with cancers which were distant from the pyloric ring (the other group). The frequency of advanced cancer was significantly higher in the pyloric ring group than in the other group. The grade of lymph node metastasis was also higher in the pyloric ring group. But in prognostic serosal invasion positive (ps (+) ) cases, there was no significant difference between the two groups. In the degree of histological differentiation, there was no significant difference between the two groups. In the cases with duodenal extension, histologically differentiated cancers tended to show localized extension and undifferentiated cancers tended to show diffused extension. As for therapeutic results, the 5-year survival rate after curative surgery was 40.7% in the pyloric ring group and 69.3% in the other group. But in ps (+) cases, there was no significant difference in the therapeutic results between the two groups.

Key words
lower gastric cancer, pyloric ring, duodenal extension of cancer

Reprint requests
Toshitaka Takehana First Department of Surgery, Yokohama City University School of Medicine
3-46 Urafune-cho, Minami-ku, Yokohama, 232 JAPAN

Accepted
April 1, 1992

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