J.Jpn. Surg. Soc.. 80(12): 1457-1460, 1979

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Report on the annual meeting

LIMITATION OF OPERATIVE THERAPY FOR ADVANCED CARCINOMA OF THE STOMACH

First, extended regional lymph node dissection (R₃) was evaluated in terms of prognosis in curative resection for advanced carcinoma of the stomach. Operative mortality was only 2.2%. Five year survival rate was 49.7% in all cases and 18.2% in the cases with metastasis to the nodes of the third group (n₃). According to the location of main tumor, R₃-resection was effective on carcinoma of the lower and middle thirds, however, not so on carcinoma of the upper third.
Second, indication of splenectomy combined with total gastrectomy for carcinoma of the upper part of the stomach was discussed. Splenectomy must be applied for the cases with carcinoma which seems to invade the tail and body of the pancreas and/or to metastasize to the nodes at splenic hilum if curative resection is possible. Otherwise, spleen had better be preserved because it might play a role in host resistance against cancer.

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