title: Should scirrhous gastric carcinoma be treated surgically? Clinical experiences with 233 cases and a retrospective analysis of prognosticators.
abstract: OBJECTIVE
  The prognosis of patients with scirrhous gastric carcinoma has been poorest.
  
  
  METHODS
  To clarify the role of surgical treatment, 233 patients with a primary scirrhous gastric carcinoma were retrospectively analyzed.
  
  
  RESULTS
  Of the 233 patients, 182 underwent surgical resection, while the other 51 did not. The median survival time of those with unresectable tumors was 88.0 +/- 15.3 days and that of those who underwent resection was 380.0 +/- 41.8 days. In the 182 patients who underwent resection, multivariate analysis revealed four significant factors; lymphatic invasion, serosal invasion, curability, and lymph node dissection. Of these, curability was the most significant. The median survival time of patients whose tumor were curatively resected was 727.0 +/- 116.3 days, significantly longer than 272 +/- 34.9 days for those whose resection ended noncuratively. In 65 patients whose tumor was curatively resected, subset analyses of factors by multivariate analyses revealed an absence of serosal invasion as the single significant prognosticator. The 5-year survival rate was 55.6% in patients with scirrhous cancer without serosal invasion.
  
  
  CONCLUSIONS
  For patients with scirrhous gastric carcinoma, palliative resection should not be attempted for poor outcome. However, if curative resection seems feasible, radical surgery would be justified, especially for tumors without serosal exposure.
authors.affiliation: Third Department of Surgery, Kanagawa Cancer Center, 1-1-2 Nakao, Asahi-Ku, Yokohama 241, Japan. kaakya@mm.neweb.ne.jp
authors.forename: T
authors.initials: T
authors.lastname: Yoshikawa
authors.forename: A
authors.initials: A
authors.lastname: Tsuburaya
authors.forename: O
authors.initials: O
authors.lastname: Kobayashi
authors.forename: M
authors.initials: M
authors.lastname: Sairenji
authors.forename: H
authors.initials: H
authors.lastname: Motohashi
authors.forename: Y
authors.initials: Y
authors.lastname: Noguchi
mesh_terms: D002293:Adenocarcinoma, Scirrhous / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate