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Tenascin expression was determined by an immunohistochemical technique in 120 surgical specimens of gastric carcinoma to investigate its relationship with clinicopathological factors. Tenascin expression was more prominent in the neoplastic area than in the adjacent non-neoplastic mucosa. Tenascin was frequently observed in gastric mucosa with diffuse chronic gastritis, glandular atrophy and intestinal metaplasia. In the neoplastic area, tenascin expression was positive in 72 cases (60 per cent). Tumours with a high frequency of tenascin expression included: Borrmann type II (19 of 20), well or moderately differentiated tumours (52 of 63), tumours with expansive growth and with an intermediate growth pattern (40 of 42), and those with a medullary or intermediate-type stroma (55 of 73). There was no significant relationship between tenascin expression and age, sex, depth of tumour invasion, lymph node metastasis, invasion to lymphatic vessel, venous invasion and the 4-year survival rate.

Objective: To assess the role of combined resection of neighbouring organs that have been invaded by cancer in patients with potentially curable, but advanced, gastric cancer., Design: Retrospective follow up study., Setting: University department of surgery., Subjects: 204 patients (from a consecutive series of 745 who had had gastric resection for cancer) all of whom had undergone potentially curative operations for advanced disease: 91 had had combined resection of other invaded organs., Results: Five year survival was 65% for 113 patients who had gastrectomy alone and 46% for 91 patients who also had other affected organs resected (p < 0.02)., Conclusion: We recommend resection of all organs that have been invaded by cancer, provided that there is no evidence such as widespread nodal involvement, peritoneal dissemination, or extensive hepatic metastases, that would make cure impossible.

Survival was determined after resection for the two main histological types of gastric carcinoma, intestinal (n = 223) and diffuse (n = 170), in 393 patients with pT1 or pT2 tumours. Lymph node metastases were present in 94 patients. The 10-year survival rate was significantly lower for patients with intestinal-type than for those with diffuse-type carcinoma (72 versus 91 per cent, P < 0.005). In patients without nodal involvement, the 10-year survival rate was still lower for those with intestinal-type cancer (70 versus 94 per cent, P < 0.01). Recurrence of carcinoma was more often by haematogenous dissemination in patients with intestinal-type cancer. Although the results of resection for pT1 or pT2 gastric carcinoma can be acceptable, the introduction of adjuvant therapy based on histological findings may be necessary for patients with the intestinal type of cancer to prevent haematogenous spread of carcinoma to the liver.