Certification of Biological Character and Therapy in Regard to the Recurrence of the Gastric Cancer

Yoshihiko Maehara, Tatsuo Oshiro, Hisao Ohiwa, Shinichi Tomisaki, Yoshihisa Sakaguchi, Tetsuya Kusumoto, Shinji Ohno, Hideo Baba, Yuji Ichiyoshi, Keizo Sugimachi

Department of Surgery II, Faculty of Medicine, Kyushu University

To determine independent risk factors for recurrence of gastric cancer, we carried out multivariate analysis using stepwise logistic regression. the multivariate analysis revealed that the presence of serosal invasion, and Borrmann type 4 cancer were the greatest risk factors for peritoneal dissemination. The presence of lymph node metastasis and vessel invasion were the greatest-risk factors for a haematogenous recurrence. We evaluated the expression of the c-erb B-2 protein and the abnormal p53 protein in gastric cancer, using monoclonal antibodies mAb 1 and PAb240, respectively. Patients with positive staining for c-erb B-2 protein had higher recurrence rates, including lymph node metastasis, hepatic metastasis and peritoneal dissemination. Tumors stained positively for p53 metastasized to lymph nodes more frequently than those with negative staining. The succinate dehydrogenase inhibition (SDI) test was used to determine chemosensitivity. Lymph node metastasis was more sensitive to anticancer drugs than the corresponding primary lesions, while hepatic metastasis was less sensitive than the corresponding primary lesion. The concomitant administration of OK-432 and anticancer drug for patients with gastric cancer invading the serosa was significantly useful treatment for the prevention of peritoneal recurrence. These data show that "type-oriented chemotherapy" is essential for patients with high risk factors for recurrence of gastric cancer based on individual biological characteristics.

Key words
gastric cancer, multivariate analysis, recurrence

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

Accepted
July 6, 1994

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