A STUDY OF GASTRIC CANCER WITH MACROSCOPICAL INVASION INTO SURROUNDING ORGANS

During the past 8 years from 1975 to 1982, 75 cases (19.3%) with macroscopical invasion into surrounding organs out of 387 cases of gastric cancer were experienced. They were divided into two groups a nonresectable groups of 41 cases (54.7%) and a resectable group of 34 cases (45.3%). In the nonresectable group, there were 21 cases (51.2%) with the tumor in the antrum and 25 cases (61%) with pancreatic invasion. On the other hand, in the resectable group there were 14 cases (41.2%) with the tumor in the middle part. The invaded surrounding organs were pancreas in 19 cases (55.9%), transverse colon in 12 cases (35.3%) and liver in 2 cases (5.9%). The operation methods were total gastrectomy in 10 cases (29.4%), subtotal gastrectomy in 17 cases (50%), partial gastrectomy in 6 cases (17.6%) and a modified Child's in procedure in 1 case (2.9%). Combined resection of the stomach and one organ was performed in 9 cases (26.5%) and with two organs in 7 cases (20.6%). Eighteen patients (54.5%) in the resectable group have survived more than 1 year and 4 (12.1%) of these for more than 5 years. If the general condition of the patients is such as to enablec them to tolerate the operation, the invaded surrounding organs should be resected with the stomach, and lymph node dissection also should be performed en-block over a wide range.