STUDIES ON GASTRIC CANCER WITH PATHOLOGICALLY “SCIRRHOUS TYPE” INFILTRATION IN STROMAL REACTION

In a recent 7-year period, 349 patients were operated on gastric cancer at the department, and 55 of them had a pathologically “scirrhous type” infiltration in stromal reaction. In this study the growth pattern, development, and prognosis of gastric cancers of this type were examined. In the fundic gland area, cancer cells that have a productivity of fibrosis may develop into the “linitis plastica type” carcinoma without ulceration before the submucosal infiltration. If the submucosal infiltration is preceded by ulceration, such cells may develop into Borrmann type 3 or 4 in approximately the same frequency through IIc advanced type. In the pyloric gland area, the carcinomas grow to be Borrmann type 3 or 4 through IIc advanced type under the influence of ulceration, where Borrmann type 3 carcinomas are more common. Commonly the scirrhous carcinomas of the stomach are far advanced, and the prognosis is very poor because of widespread peritoneal dissemination and lymph node involvement. However, if these cases are resected in the depth of “sm or pm”, there is no recurrence and death case in our experience, and the prognosis is expected as well.