Certification of Biological Character and Strategy for Treatment in Regard to the Metastasis of the Gastric Cancer

Yoshihiko Maehara, Tatsuo Oshiro, Hisao Ohiwa, Kazuya Endo, Yoshihiro Kakeji, Hiroyuki Orita, Toshiro Okuyama, Liu Qi, Shinji Ohno, Hideo Baba, Keizo Sugimachi

Department of Surgery II, Faculty of Medicine, Kyushu University

To determine independent risk factors for metastasis of gastric cancer, we carried out multivariate analysis using stepwise logistic regression. The multivariate analysis revealed that the presence of serosal invasion, c-erB-2 protein expression, abnormal p53 expression and DNA high ploidy are independent risk factors for lymph node metastasis. The presence of serosal invasion and venous involvement were independent risk factors for liver metastasis. The presence of serosal invasion, undifferentiated types and the expression of c-er B-2 were independent risk factors for peritoneal dissemination. The succinate dehydrogenase inhibition (SDI) test was used to determine chemosensitivity. The sensitivities were relatively higher in poorly differentiated tissues than in well-differentiated tissues. Lymph node metastasis was more sensitive to anticancer drugs than the primary lesions, while hepatic metastasis was less sensitive than the primary lesion. The concomitant administration of OK-432 and anticancer drug for patients with gastric cancer invading the serosa significantly decreased the rates of peritoneal recurrence and improved survival rate. These data show that "type-oriented chemotherapy" is essential for highrisk gastric cancer patients based on individual biological characteristics.

Key words
gastric cancer, multivariate analysis, metastasis

Reprint requests
Yoshihiko Maehara Department of Surgery II, Faculty of Medicine, Kyushu University
3-1-1 Maidashi, Higashiku, Fukuoka, 812 JAPAN

Accepted
December 8, 1993

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