Borrmann 4型胃癌の外科治療成績

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  • CLINICAL STUDY OF BORRMANN TYPE 4 GASTRIC CANCER

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A clinicopathological study was undertaken in 44 patients with Borrmann type 4 gastric cancer. The male: female ratio was 1.10:1 and the average age was as high as 53.8 years. Total gastrectomy was performed in 77.3%, lymphadenectomy (R2 and above) done in 67.4% and combined resection of adjacent organs done in 56.8%. Peritoneal dissemination and liver metastasis occurred at rates of 31.0% and 4.8%, respectively. Histological examination revealed poorly differentiated adenocarcinoma and the depth of gastric wall invasion exceeded “se” in many cases. The incidence of histological lymph node metastasis was 73.1%. Cross-sections of the ends of excised tissue specimens disclosed a high incidence of tumor infiltration (20.9%). The overall prognosis of Borrmann type 4 gastric cancer was exceedingly poor. The 1, 3 and 5 year survival rates were 55.1%, 19.1% and 13.5%, respectively. In the comparison of curative resection and non-curative resection, significant differences were found in survival rates of the 1 and 3 years. One P1 patient who received total gastrecotmy with combined resection of metastatic lesion survived more than 5 years. From the above, extended radical operation is necessary to improve the prognosis in Borrmann type 4 gastric cancers.

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