Hiroki Kawaguchi

Therapeutic significance of noncurative gastrectomy for gastric cancer with liver metastasis

The therapeutic significance of noncurative gastrectomy for gastric cancer with liver metastasis was evaluated and the histologic characteristics of such cancer examined. The mean postoperative survival time of patients with liver metastasis limited to one lobe or a few scattered metastases to both lobes without peritoneal metastasis or direct cancer invasion to other organs was significantly prolonged by noncurative gastrectomy. Differentiated adenocarcinoma, including papillary adenocarcinoma, and intravenous cancer invasion were found to be the histologic characteristics of gastric cancer with liver metastasis.

Clinical and pathologic evaluation of patients with recurrence of gastric cancer more than five years postoperatively

From the clinical and pathologic findings, the characteristics of recurrence of gastric cancer more than five years postoperatively were evaluated as compared with recurrence of less than five years postoperatively. The late (more than 5 years postoperative) recurrence rate was 2.0 per cent, or 17 of 864 patients who had undergone the so-called radical operation. The duration of disease prior to the first operation was comparatively long in the patients with late recurrence. Late recurrence is characteristic of localized cancer, such as Borrmanns type II, and differentiated adenocarcinoma with nonserosal invasion (pathologic findings of the resected stomach at the first operation) and by a recurrence pattern of hematogenous metastasis, especially liver metastasis.

Significance of mass survey for gastric cancer from the standpoint of surgery

From the standpoint of surgery, results for gastric cancers detected by mass survey were better than for cases found on outpatient examinations, partly because the proportion of early cancers was greater in the former group. The results for advanced cancers were also better in the mass survey group.

Results of total gastrectomy for gastric cancer.

To compare the results of total gastrectomy performed during the last 30 years, we classified 256 patients into four chronologic groups. Despite advances facilitating early detection of gastric cancer, the percentage of patients with stage IV cancer was not significantly different among the four groups. However, operative mortality decreased and curability increased in the two most recent groups. The 5 year survival rate was significantly increased in patients operated on after 1960. Our results show that in Japan, operative mortality and 5 year survival compare favorably with reports from Western countries.

Chronologic comparison of postoperative results in gastric cancer surgery.

Patients who underwent gastric cancer surgery in our clinic during a 12-year period from 1960–1971 were divided into two groups. Group A is comprised of patients who were treated in the first, and group B of patients treated in the second half of this 12-year period and the short- and long-term results were evaluated and compared for both groups. We discovered that both short- and long-term results were better in group B than in group A. Group B contained more cases of histologically early cancer stages and extensive lymph node resection was performed more frequently in group B than in group A. These factors may account for the better results obtained for group B. In addition, performance of gastrectomy combined with the resection of other neighboring organs may have effected the better long-term results observed in group B.