Effect of Adjuvant chemotherapy on the Recurrence of Peritoneal and Hematogeneous Metastases

Keiichiro Ohta, Toshifusa Nakajima, Shigekazu Ohyama, Shou Ishihara, Mitsumasa Nishi

Division of Surgery, Cancer Institute Hospital

High risk groups for peritoneal and hematogeneous metastasis were selected from 1027 cases of gastric cancer treated with curative gastrectomy from 1960 to 1990. Patients with distant metastasis and with invasion to the adjacent organs were excluded from the analysis. The high risk group for peritoneal dissemination was characterized by the large infiltrative tumor type with serosal and nodal involvement,and poorly differentiated type. On the other hand, high risk factors for hematogeneous metastasis involved older patients (over sixty years old) who had localized tumor type, differentiated tumor type (papillary and tubular adenocarcinoma), and lymph node involvement. The survival benefit of adjuvant chemotherapy for these groups was studied. Conventional adjuvant chemotherapy with MMC and 5FU did not control peritoneal dissemination, but inhibited hematogeneous metastasis. A regional approach (i.p. administration) might be necessary for the control of peritoneal dissemination.

Key words
gastric cancer with serosal invasion, peritoneal dissemination, hematogeneous metastasis

Reprint requests
Keiichiro Ohta Division of Surgery, Cancer Institute Hospital
1-37-1 Kamiikebukuro, Toshima-ku, Tokyo, 170 JAPAN

Accepted
July 6, 1994

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