Relationship between hematogenic metastasis of gastric cancer and the maximum extent of venous invasion by cancer cells in the gastric wall.
OBJECTIVE
The prognosis or the incidence of hematogenic metastasis after operation in patients with gastric cancer with venous invasion by cancer cells is still unclear.


METHODS
The correlation was examined between venous invasion by gastric cancer and the occurrence of hematogenic metastasis in patients with gastric cancer at stage t2 (tumor had invaded muscularis propria or subserosa).


RESULTS
The incidence of venous invasion by cancer cells in 228 patients with t2 gastric cancer was 53.5%, as determined histologically. Between 1977 and 1993, 32 of these 22 patients died from hematogenic metastasis. Thirty of the 32 patients (93.8%) with hematogenic metastasis had evidence of venous invasion by cancer cells of the gastric wall. Furthermore, 17 of the 30 patients (56.7%) had venous invasion at the subserosal layer of the stomach (ssv). However, of 196 patients without hematogenic metastasis, 92 patients had venous invasion and only 8 of 92 patients (8.7%) had ssv. The mean maximum extent of ssv in 8 patients without hematogenic metastasis was 2.28 mm but it was 4.76 mm in 17 patients with hematogenic metastasis (P = 0.028).


CONCLUSIONS
Thus, the hematogenic metastasis of gastric cancer was very closely related to the presence of extensive venous invasion by cancer cells of the subserosal layer in the gastric wall.
Ikeguchi
M
M
Department of Surgery I, Faculty of Medicine, Tottori University, Yonago, Japan.
Katano
K
K
Oka
A
A
Tsujitani
S
S
Maeta
M
M
Kaibara
N
N
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000556:secondary*; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate