title: [Peritoneal dissemination of scirrhous type 4 gastric cancers].
abstract: We examined 198 cases of primary scirrhous type 4 gastric cancer at our department from 1984 to 2003. Of these, 139 cases underwent gastrectomy. The essential cause of inoperability was peritoneal dissemination with malignant abdominal abscises. The incidence of peritoneal dissemination was 48.2% of all resected cases. The 5-year survival rate of all resected cases was 12% and that of non-resectable cases was 0%. One of the 59 nonresectable cases who responded remarkably to treatment by TS-1/paclitaxel combination chemotherapy obtained survival of 12 months. Six cases with peritoneal dissemination were treated by chemotherapy with cisplatin and etoposide infused intra-peritoneally and 2 of them were diagnosed as P 0 after 4 weeks. One case with type 4 gastric cancer who had right hydronephrosis and malignant abdominal ascites underwent curative resection after successful treatment with TS-1. We have selected the way of conventional chemotherapy for inoperable type 4 gastric cancers, but the prognosis is still poor. It is thought necessary to improve survival by newly developed anticancer agents such as TS-1, etoposide and taxanes. Immuno-cellular therapy with autologous tumor cell stimulated lymphocyte may be examined as a neo-adjuvant therapy as well as chemotherapy.
authors.affiliation: Dept. of Surgery, Kurume University School of Medicine.
authors.forename: Kikuo
authors.initials: K
authors.lastname: Koufuji
authors.forename: Keishirou
authors.initials: K
authors.lastname: Aoyagi
authors.forename: Shojirou
authors.initials: S
authors.lastname: Yano
authors.forename: Naotaka
authors.initials: N
authors.lastname: Murakami
authors.forename: Motosi
authors.initials: M
authors.lastname: Miyagi
authors.forename: Takuya
authors.initials: T
authors.lastname: Imaizumi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Shirouzu
mesh_terms: D002293:Adenocarcinoma, Scirrhous / Q000188:drug therapy / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D004338:Drug Combinations; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007167:Immunotherapy; D008297:Male; D008875:Middle Aged; D010094:Oxonic Acid / Q000008:administration & dosage; D017239:Paclitaxel / Q000008:administration & dosage; D010534:Peritoneal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000556:secondary*; D011725:Pyridines / Q000008:administration & dosage; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate; D005641:Tegafur / Q000008:administration & dosage
chemical_list: D004338:Drug Combinations; D011725:Pyridines; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D005047:Etoposide; D017239:Paclitaxel; D002945:Cisplatin