CLINICAL STUDY ON SCIRRHOUS CARCINOMA OF BORRMANN TYPE 4 GASTRIC CANCER

Abstract

A clinicopathological study was undertaken in 74 patients with scirrhous carcinoma of Borrmann type 4 gastric cancer. (1) Macroscopically, the majority belonged to the linitis plastica type with giant folds. Most tumors measured 6-15 cm in diameter. (2) Total gastrectomy and lymphadenectomy (R2 and above) were performed in 77.0%, and gastrectomy with perigastric organ resection in 55.4%. (3) Histological examination revealed poorly differentiated adenocarcinoma in most cases. The depth of gastric wall invasion exceeded “se” in many cases. (4) Liver metastasis and peritoneal dissemination occurred at rates of 5.4% and 35.1%, respectively. The incidence of lymph node metastasis was a high 81.1%. (5) Cross-sections of the ends of excised tissue specimens disclosed a high incidence of tumor infiltration (23.0%). (6) The overall prognosis of scirrhous gastric carcinoma was exceedingly poor. The 1-, 3- and 5-year survival rates were 59.5%, 16.1% and 9.3%, respectively. In comparing curative resection and non-curative resectin, no significant differences were found in survival rates except for the 1-year survival rate (p<0.001). The prognosis of patients with lymph node metastasis was poor. In patients without peritoneal dissemination, the long-term prognosis was poor, though the 1-year survival rate alone was a high 75.0%. (7) The peritoneum was the most frequent site of recurrence in curative resection patients.