We investigated the postoperative deaths and recurrence among 673 patients with early gastric cancer who had undergone gastric resection at the National Kyushu Cancer Center Hospital from March 1972 to December 1988. The mode and time of recurrence were assessed with reference to the clinicopathological findings at initial surgery. Fifteen patients (2.2%) died of cancer recurrence, and 18 patients (2.7%) developed recurrence (3 patients are currently alive after reoperation). A comparison of modes of recurrence revealed that the incidence of hematogenous recurrence was the highest with nine cases, followed by recurrence in the remnant stomach in three cases and by local, lymph node, and peritoneal recurrences in two cases each. Twelve patients developed recurrence within 5 years after operation (early recurrence) and six patients after 5 years (late recurrence). Cases positive for cancer cell invasion into intralesional veins at initial surgery had a significantly higher recurrence rate than negative cases (P less than 0.001). Thus, venous invasion was the most important factor for the development of recurrence in the patients with early gastric cancer.

Adenocarcinoma↗

PubMedDate not supplied

Peritoneal dissemination after a curative gastrectomy in patients with undifferentiated adenocarcinoma of the stomach.

Peritoneal dissemination is the major pattern of recurrence in patients with gastric cancer. Among the 1,337 patients with gastric cancer who underwent a curative resection, a multivariate analysis showed that the independent risk factors for the occurrence of peritoneal dissemination were an undifferentiated tissue type and serosal invasion. We focus our attention on 477 patients with undifferentiated type tumor, in which the postoperative prognosis and the pattern of recurrence after curative resection were evaluated with regard to the depth of the cancerous invasion in the gastric wall. Patients with tumors limiting to the subserosal layer had a satisfactory post-operative course, with five-year survival rates of 98.5%, 97.4%, and 82.5% in patients with tumors limiting to the submucosal layer, the muscularis propria and subserosal layer, respectively. In 179 patients with tumors invading to the subserosal layer, however, the five year survival rate was only 48.2%. Seventy-one died of peritoneal dissemination, while 24 and 15 were due to hematogenous and local recurrences, respectively. Only 50 (27.9%) survived over 5 years without any recurrence.

Adenocarcinoma↗

PubMedDate not supplied

Clinical evaluation of gastric fundic gland polyps without familial polyposis coli.

BACKGROUND: Assessments were made of 63 cases of fundic gland polyposis (FGP) unassociated with adenomatosis coli. These cases were evaluated by radiological examination over 2 years follow-up. All polyps were pathologically confirmed by endoscopic biopsies. METHODS: Most cases were asymptomatic when diagnosed during mass radiological surveys of the upper gastrointestinal tract. The majority of patients ranged in age from 40-60 years, and the polyps numbered fewer than 20 in 55 cases (87.3%). Polyps were detected in the fundic glands using the congo red test and by biopsies. RESULTS: All serum gastrin values were within the normal range. During the course of this study, the polyps of 13 cases (20.6%) increased and those of three cases (4.8%) decreased or resolved completely. CONCLUSION: From these findings it is considered that FGP are observed in stomachs with less atrophy, and that polyps follow courses in which they increase, decrease, disappear, along with atrophy.

Adenomatous Polyposis Coli↗