Tsuneyuki Okamoto

Clinical evaluation of long-term srvival after total gastrectomy

Twenty-seven cases of long-term survival after total gastrectomy were clinically evaluated. From the standpoint of general nutrition and rehabilitation, the patients appeared to be in satisfactory condition. However, hyperchromic anemia, serum vitamin B12 deficiency, and osteoporosis were noted in some patients.

Comparative study on the nuclear DNA content of leiomyoma, leiomyoblastoma and leiomyosarcoma of the stomach and small intestine.

The nuclear DNA content of tumor cells in 5 leiomyomas, 4 leiomyoblastomas and 2 leiomyosarcomas of the stomach and 1 leiomyosarcoma of the small intestine was examined. From the viewpoint of nuclear DNA content, leiomyoblastoma was between leiomyoma and leiomyosarcoma. A definite difference in nuclear DNA content exists among leiomyoma, leiomyoblastoma and leiomyosarcoma, and percentage of nuclei with a DNA content 3 times or 4 times over the basic chromosome content represented good indices for distinguishing between benign and malignant conditions. A diagnosis of leiomyocarcoma may be more accurate when over 80% of the nuclei have DNA content values over 3 times of basic nuclear DNA content and when over 50% exhibit more than 4 times of basic content.

Comparative Study of Gastric Cancer in Young and Aged Patients

Clinical and pathological findings of gastric cancer in patients of less than 30 years of age were compared with those in aged patients of over 75 years of age. These were 10 males and 24 females, and the rate of gastric cancer for females in the younger group was extremely high. There were marked differences between both groups in the pathological findings of gastric cancer, and consequently in the progressive pattern of the disease, perhaps as the result of differences in the matrix of cancer development and the influence of sex hormones. Gastric cancer at an advanced stage and delayed surgery in younger patients are attributable to negligence on the part of the patient in scheduling a medical examination and careless diagnosis by the physician. However, the prognosis of gastric cancer was not unfavorable in the younger patients when curative surgery was performed.

Nuclear DNA content in dimethylhydrazine‐induced colonic carcinoma and mucosal dysplasia in rats

Mucosal dysplasia and carcinoma infiltrating the submucosal layer were induced in rats with dimethylhydrazine. The nuclear DNA content of the cells was measured, and the correlation between the DNA distribution pattern and histopathologic findings was evaluated. In mild and moderate dysplasias, histograms of the nuclear DNA content showed a narrow range of distribution with a sharp peak in the diploid area. In severe dysplasia, however, there was wide distribution and no peak value; this was reminiscent of carcinoma. Based on the findings of this report, the authors suggest that severe dysplasia be regarded as intramucosal carcinoma.

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.

Possible role of lymph node dissection in the surgical treatment of gastric cancer with disseminating peritoneal metastasis

Pathological background factors of patients with gastric cancer and peritoneal metastasis were studied. In palliatively gastrectomized patients, there was a close relationship between the extent of cancer invasion to the gastric serosa and postoperative survival; the less extensive the serosal invasion, the longer was the survival time. The relationship between the extent of lymph node dissection and postoperative survival showed that, in the presence of metastasis to Group 1 and 2 lymph nodes, many of the long-term survivors had undergone dissection of these lymph nodes. Although a sweeping conclusion should be avoided since retrospective analysis forms the basis of this report, it is assumed that in patients with gastric cancer and peritoneal metatasis, surgery should not be confined to resection of the primary focus, but should include regional lymph node dissection.

Comparison of 5- and 10-year survival rates in operated gastric cancer patients

ZusammenfassungUm herauszufinden, ob die 5-Jahres-Überlebensrate tatsächlich aussagekräftig betreffs der postoperativen Heilungsquote ist, wurden die 5- und 10-Jahres-Überlebensraten bei 477 Patienten mit primärem Magencarcinom verfolgt, die während einer 8-Jahresperiode von 1960 bis 1967 gastrektomiert wurden. Bei den Patienten, die mehr als 5 Jahre nach der Operation verstarben, wurde die Todesursache untersucht. Die 10-Jahre Überlebensrate von 315 kurativ operierten Patienten, lag bei 59,1% d. h. 3,9% niedriger als die 5-Jahres-Überlebensrate. Von 176 Patienten, die mehr als 5 Jahre nach der Krebsoperation überlebten, verstarben nur 9 (5,1%) an einem Krebsrezidiv. Somit wird demonstriert, daß die 5-Jahres-Überlebensquote tatsächlich den Heilerfolg bei der Magenkrebschirurgie adäquat reflektiert.SummaryTo evaluate whether it is appropriate to estimate the postoperative curability of gastric cancer based on the 5-year survival rate, we compared 5- and 10-year survival rates in 477 primary gastric cancer patients who had undergone gastrectomy during the 8-year period from 1960–1967. In patients who had died more than 5 years after surgery, the cause of death was investigated. The 10-year survival rate of 315 curatively operated patients was 59.1%, 3.9% lower than the 5-year survival rate. Of 176 patients who survived more than 5 years postoperatively, only 9 (5.1%) died of cancer recurrence, suggesting that the 5-year survival rate adequately reflects the curative success of gastric cancer surgery.

Significance of pelvic retroperitoneal pneumography in the assessment of extramural invasion of rectal carcinoma

Pelvic retroperitoneal pneumography (PRP) and barium enema were performed simultaneously in 34 patients with rectal carcinoma in an attempt to assess whether there was extramural cancer invasion. In 9 patients, no free air was visualized in the retroperitoneal cavity surrounding the mass, and histological evaluation of the excised specimens showed extramural invasion in all 9. The mean maximum diameter was 4.1 cm. In 25 patients, free air was seen around the mass, and 10 had tumors limited to the rectal wall, the remaining 15 manifested extramural invasion, however, the mean diameter was small (2.0 cm). In a mass whose center was located along the anterior rectal wall, it was difficult to assess from the free air findings whether there was extramural invasion. Based on the present findings, we concluded that PRP is useful in determining preoperatively whether there is extramural invasion in cases with rectal carcinoma involving the posterior and lateral walls.