Clinicopathological factors influencing the survival and the effect of chemotherapy with special reference to S-1 were retrospectively analyzed in 41 patients who underwent gastrectomy for stage IV gastric cancer. Significantly better outcomes were observed in patients with H0, P0 or M0 than those with H1, P1 or M1, respectively. Curability B surgery showed a significantly better result than curability C. A significantly better result was demonstrated in patients treated with S-1 alone than those treated with chemotherapy other than S-1 or in patients without chemotherapy. Multivariate analysis revealed that H0, M0 and chemotherapy with S-1 were significant and independent prognostic factors. Moreover, the patients treated with S-1 for more than 12 months showed a significantly better outcome than those treated with S-1 for less than 12 months. It is concluded that curative resection (curability B) and the longer period of postoperative chemotherapy with S-1 is the treatment of choice to improve the outcome of patients with stage IV gastric cancer.
We have previously demonstrated significantly decreased immu‐noreactivity of hepatocyte growth factor activator inhibitor type 1 (HAI‐1), an integral membrane protein that exhibits potent inhibitory activity against hepatocyte growth factor activator (HGFA) and matriptase, in colorectal adenocarcinomas. In this report, we describe further detailed analysis of HAI‐1 expression in colorectal adenocarcinoma by using three kinds of anti‐HAI‐1 antibodies, each of which recognizes a distinct epitope of the HAI‐1 molecule, and also by in‐situ hybridization for HAI‐1 mRNA. The results indicated that the decreased immunoreactivity of HAI‐1 in colorectal carcinoma cells is largely a result of enhanced ecto‐domain shedding of HAI‐1 in these cells. In contrast, immunore‐activity of mature membrane‐form HAI‐1 was paradoxically enhanced in cancer cells at the invasion front, showing intense cell‐stroma interactions and/or sprouting invasion. This finding indicates that these invading cells showed decreased ectodomain shedding of HAI‐1 and consequently might require the existence of the membrane‐form HAI‐1. Of particular interest was the observation of a possible inverse correlation between paradoxical up‐regulation of membrane‐form HAI‐1 expression and membrane‐associated E‐cadherin in these cells. These membrane‐form HAI‐1‐positive sprouting cancer cells were also negative for MIB‐1 immunohistochemically, indicating a low‐proliferating population. All these results suggest that HAI‐1 may mediate diverse functions in regard to the progression of colorectal carcinomas, and the immunoreactivity of membrane‐form HAI‐1 may serve as a marker of invading cancer cells.
A 68-year-old male was found an abnormal shadow on chest X-ray and was diagnosed as thymoma by computed tomography (CT)-guided needle biopsy. As the tumor invaded the aortic arch, left main pulmonary artery and the lung, thymectomy combined resection of the surrounding tissues was performed for the complete resection. The aortic arch was replaced with cardiovascular graft under cardiopulmonary bypass, with the aid of selective cerebral perfusion. The left pneumonectomy was performed because the tumor invaded to the left main pulmonary artery and to the lung parenchyma. Masaoka stage III and histologic type B2 were diagnosed according to the World Health Organization classification. The patient has been well without recurrence or metastasis after the surgery for 2 years. A complete resection of the thymoma invaded to great vessels should be performed to expect for the good curability and prognosis.
