J.Jpn. Surg. Soc.. 78(5): 395-407, 1977
Original article
A CLINICOPATHOLOGICAL STUDY ON THE UPPER GASTRIC CANCER WITH SPECIAL REFERENCE TO THE CHOICE OF OPERATIVE PROCEDURE
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The First Department of Surgery, Tohoku University School of Medicine (Director : Prof. T. Sato) Tadanobu Watanabe, Akira Sakuma |
The cases accompanied with inferior gastric lymphnodes metastases, serosal invasion and the tumor over 4 cm in diameter were easily metastasized to the subpyloric lymphnodes. In these cases, 5-year survival rate of proximal gastrectomy was poor compared to that of total gastrectomy.
Esophageal involvement was demonstrated in 104 cases and the distance of histological invasion were measured. Pre-operative X-ray findings and the gross configuration of tumor appeared to the important factors in regard to the distance of invasion ; six cases with obstruction in the lower esophagus in X-ray films and infiltrating type in gross configuration had invasion over 3 cm into the esophageal wall histologically.
An attempt was made to examine the gross serial sections on the hilum of the spleen. There were 37 metastatic lymphnodes under 5 mm in diameter and another minimal metastatic focuses as intravascular invasion or direct cancer infiltration. These results indicate the rationale of extended total or proximal gastrectomy for the upper gastric cancers.
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