Abstract
Cases of recurrent t1 cancer of the stomach were studied clinicopathologically with reference to the clinical course to evaluate the effect of fluoropyrimidine compound administration versus nonadministration. Thiryt-four of the 907 patients with t1 cancer of the stomach (3.7%) died of recurrence. Among them, five of 495 cases were characterized by invasion of the mucosal layer, while 29 of 412 showed invasion of the submucosal layer. Ten, ten, seven and seven cases were classified as stage 1, stage 2, stage 3 and stage 4, respectively. Five stage 1 cases manifested recurrence after 5 years while one curious case of recurrence occurred in the gastrectomized region 10 years later. All five cases of mucosal cancer of the protruding type developed recurrence. Five of the 63 cases of protruding submucosal cancer, and 12 of the 109 cases of mixed (elevated-depressed) type developed recurrence. Despite the low percentage of recurrence (1.3%) in node-negative disease, 24 of 73 cases of node-positive (32.9%) disease died of recurrence. Histologically, 14 of 29 patients with submucosal cancer (48%) showed well differentiated cancer, including 12 cases of papillary adenocarcinoma. No prognostic significance was associated with patients with node-negative and vascular or lymphatic invasion who received administration of anticancer drugs, compared with non-administered cases. In conclusion, gastrecotmy with careful attention to lymph node dissection is indicated for patients with t1 cancer of the stomach showing protruding or mixed type disease macroscopically or papillary adenocarcinoma histologically.
