Abstract
The subjects were 300 patients with gastric cancer with peritoneal metastasis discovered at laparotomy. We investigated the effects of surgical treatment and chemotherapy on the outcome of these cases. The rates of resection in P1, P2 and P3 cases were 83.5%, 83.1% and 38.1%, respectively, with a total rate of 64.3%. The survival rate decreased with advance in P-progress in overall P (+) cases. There were significant differences in survival rate between P1 and P3 (p<0.001), and P2 and P3 (p<0.05). In P (+) cases with gastrectomy, there was a significant difference in survival rate between P1 and P3 (p<0.05). No differences in survival rate were found in non-resected cases. As for the outcome of these cases according to the degree of lymph node dissection, R2 was significantly better than R0 in P1 (p<0.05). Although we augmented the degree of lymph node dissection in P2 and P3 cases, no significant increase in the survival rate occurred. We studied the effect of chemotherapy. Concerning the outcome of non-resected cases, the cases with chemotherapy showed significantly better results than those without chemotherapy (p<0.001). The outcome of resected cases with chemotherapy was also better than that without chemotherapy. Treatment by sequential MTX-5FU was regarded as more effective in the present investigation than 5FU, MMC·5FU and ADM·5FU therapy. Consequently, we concluded that it is necessary to determine not only appropriate operative indications and lymph node dissection but also effective chemotherapy in P (+) cases.
