Prognostic Factor of Recurrence and Lymph Node Dissection for Gastric Cancer

Tetsuro Nishida, Sumitaka Arima, Kitaro Futami, Koichi Yamasaki, Tassei Okamoto, Tsuyoshi Koto, Satoshi Tateishi, Shuzo Tateishi, Fumiaki Hara, Kenya Ohkawara, Kunihiro Kitamura

Department of Surgery, Chikushi Hospital, Fukuoka University

We evaluated the clinico-pathologic factors affecting the postoperative disease free interval in 354 patients who underwent curative and relative non-curative dissection for gastric cancer. The incidence of recurrence was 0/203 (0%) in stage 1,8/59 (14%) in stage II, 23/68 (34%) in stage III, and,12/24 (50%) in stage IV. We divided the patients into two groups based on recurrence or non-recurrence in each stage, and statistically significant factors associated with recurrence were selected. The factors were ps(+), INFγ, the number of metastatic lymph nodes in stage II, ps(+), INFγ, Borrmann 4, tumor size, Circ, the number of metastatic lymph nodes in stage III, ps(+), A+M, and the number of metastatic lymph nodes in stage IV. The organs of recurrent lesions were peritoneum (51%), liver (23%), lymph node (19%), and distant organs (7%) in overall stage. The shortest disease free interval was about 7 months in stage IV, and the longest was about 3 years in distant metastasis. The prognoses of the patients with the extended lymph node dissection (R₃ or R₂+No. 16 dissection or R₃+No. 16 dissection) were favorable for the differentiated type gastric cancer in stage III, and all histologic types in stage IV. The prevention of peritoneal metastasis depends on effective adjuvant chemotherapy, for example, intraperitoneal injection of anticancer agents.

Key words
recurrence of gastric cancer, prognostic factor, lymph node dissection

Reprint requests
Tetsuro Nishida Department of Surgery, Chikushi Hospital, Fukuoka, University
377-1 Ooaza-zokumyoin, Chikushino, 818 JAPAN

Accepted
December 8, 1993

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