[Treatment of gastric cancer based on the pathological and biophysiological aspects of cancer].
Spread of the gastric cancer is multifarious according to its pathological and biophysiological characteristics. The therapeutic strategy was reviewed by the analysis of more than 8.000 cases of gastric cancer treated at Cancer Institute Hospital. Main type of recurrence in early stage cancer was, though seldom, the hematogenous metastasis to the liver. On the other hand, in the advanced cases, macroscopically localized, and histologically well differentiated tumor type easily adhered and invaded to the adjacent organs and structures, and infiltrating and undifferentiated tumor type tended to cause peritoneal dissemination. Lymph node spread was observed in any tumor type, but frequently observed in intermediate type. Invasion to the adjacent organs and limited lymphatic spread can be controlled by wide combined resection of adjacent organs, and extended lymphadenectomy. However, hematogenous metastasis and peritoneal dissemination are difficult to be controlled by surgical intervention. Thus, minor surgery can be directed for small early stage cancer under strict criteria, and wide and extended resection for localized type, and combination of surgery and adjuvant chemotherapy for intermediate and infiltrating tumor types advancing more than stage II.
Nishi
M
M
Nakajima
T
T
Ohta
H
H
D003131:Combined Modality Therapy; D005743:Gastrectomy / Q000401:mortality; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D016685:Mitomycin; D008937:Mitomycins / Q000627:therapeutic use; D009361:Neoplasm Invasiveness; D009360:Neoplastic Cells, Circulating; D010844:Picibanil / Q000627:therapeutic use; D011379:Prognosis; D013270:Stomach / Q000473:pathology*; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*
D008937:Mitomycins; D010844:Picibanil; D016685:Mitomycin