Abstract
Three hundred two patients with advanced gastric cancer were examined serially by endoscopy. They were 213 patients who received no preoperative chemotherapy, 51 those who received preoperative chemotherapy and 38 inoperable patients who were treated with chemotherapy alone. The endoscopic changes and the histopathological findings of biopsy specimens or resected stomach were investigated in relation to chemotherapy. It was found that there were several endoscopic features characteristic to chemotherapy, such as flattening of elevated lesion, shallowing of depressed lesion, smoothening of irregularity, amorphous flattening of the base of ulcerative lesion, blunting of demarcation between normal and cancerous lesion, appearance of monotonous redness in and or around depressed lesion and recovery of limited elasticity. Whenever more than 2 of the endoscopic changes mentioned above were observed, the chemotherapy could be regarded as effective even without any association of decrease in tumor size. According to these results, a new endoscopic grading of anticancer chemotherapy for gastric cancer was proposed. It is composed of progressive disease, no change and improvement which is subclassified as Grade I, II, III, and the endoscopic findings reported here were included in Grade I, even though they are not associated with a decrease in tumor size.
