A STUDY OF GASTRIC CANCER WITH HISTOLOGIC SEROSAL INVASION

The relationships of the long-term results with the extent of lymph node metastasis and the area of macroscopic serosal invasion were studied in 132 cases of stomach cancer with histologic serosal invasion (se) after R2 or more extensive lymph node dissection (excluding cases after absolutely non-curative resection. H(+), P(+), si, and sei, and patients who died due to other causes).1) The long-term results in patients positive for serosal invasion were poor even at n(-) and n1(+) levels, but no difference was observed between these two groups. The outcomes were especially poor in n2(+) and n3(+) cases.2) No correlation was observed between the area of serosal invasion and the long-term results in the entire se group.3) The long-term results were correlated with the area of serosal invasion and the number of lymph nodes involved in the n2(+) group, but no such correlations were noted in the n(-), n1(+), or n3(+) group. From these results, (1) measures to prevent peritoneal recurrence regardless of the area of serosal invasion, and (2) even more extensive lymph node dissection inclusive of paraaortic lymph nodes in n2(+) and n3(+) cases, are considered to be needed to improve the long-term prognosis of se cancers.