Clinical Gastroenterology Vol.27 No.9(1)

Theme Diagnosis and Treatment of Scirrhous Gastric Cancer -- Current Status and Future Prospects
Title Clinico-pathological Features and Epidemiology of Scirrhous Carcinoma
Publish Date 2012/08
Author Kikuo Koufuji Department of Surgery, Kurume University School of Medicine
Author Keishirou Aoyagi Department of Surgery, Kurume University School of Medicine
Author Motoshi Miyagi Department of Surgery, Kurume University School of Medicine
Author Junya Kizaki Department of Surgery, Kurume University School of Medicine
Author Tarou Isobe Department of Surgery, Kurume University School of Medicine
Author Kousuke Hashimoto Department of Surgery, Kurume University School of Medicine
Author Kazuo Shirouzu Department of Surgery, Kurume University School of Medicine
[ Summary ] We examined 198 cases of primary scirrhous type 4 gastric cancer at our department from 1984 to 2003. Of these, 139 cases underwent gastrectomies. The essential cause of inoperability was peritoneal dissemination with malignant abdominal ascites. These patients were divided into 2 groups according to the period they were treated, as follows; the former period was from 1984 to 1993 and consisted of 105 cases (7.9 %), the latter period was from 1994 to 2003 and consisted of 93 cases (6.5 %). The incidence of scirrhous carcinoma statistically decreased in the later period. On the other hand, the rates of resection and the mean age statistically increased in the later period. There were no statistical differences in male to female ratios, location of cancer, incidence of lymph node metastasis, peritoneal metastasis, liver metastasis or surgical methods between the two periods. The incidence of lymph node metastasis and peritoneal dissemination were very high in both periods. The 5-survival year rate for resected cases in the former period was 13.2 %. In the latter period was 8.5 %. The number of 5 year survival resected cases was 4 in the former period and that was 4 in the latter period. Seven of the 5 year survival patients were those with N0 or N1 lymph node metastasis. There is a need for further efforts to achieve early detection and to develop new strategies for therapies to improve the prognoses for scirrhous carcinoma.
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