| Theme |
Diagnosis and Treatment of Scirrhous Gastric Cancer -- Current Status and Future Prospects |
| Title |
The Strategy of Surgical Treatments to Improve the Prognosis for Scirrhous-type Gastric Cancer |
| Author |
Ikuo Wada |
Department of Gastrointestinal Surgery, The University of Tokyo |
| Author |
Yasuyuki Seto |
Department of Gastrointestinal Surgery, The University of Tokyo |
| [ Summary ] |
The prognosis for scirrhous-type gastric cancer is extremely poor owing to its frequent peritoneal dissemination and lymph node metastases. Because the outcome of surgery-alone is not satisfactory, adjuvant chemotherapy with S-1 is recommended when standard gastric resection can be performed curatively or non-curatively simply due to positive peritoneal lavage cytology. Neoadjuvant chemotherapy using S-1 and CDDP is expected to improve surgical treatment results. Systemic chemotherapy without primary tumor resection should be the initial treatment of choice unless surgical resection without macroscopic residual tumor can be accomplished. Intestinal tract or urinary tract obstructions due to peritoneal dissemination are common clinical manifestations in advanced cases. There has not been any demonstrated efficacy for palliative resection of the stomach to prevent occurrence of clinical symptoms. |