Abstract
Surveys were made on the patients of gastric cancer chiefly by the histopathological investigations covering the period from the time of their surgical treatment to the time of their death by recurrence. Surgical materials were obtained from the 106 gastric cancer patients received gastrectomy during the 4 years and 2 months period from April 1956 to May 1960 in the Surgical Department of Showa Medical School, and pathoanatomical materials were collected from the 22 autopsy cases of the patients died of recurrence. In most of the 106 cases, the regional gastric lymphnodes were cleaned out extensively at the time of operation. Stated in the following are the results obtained from the surveys:
1. Histologically, the positive rate of lymphatic metastasis was 72.6% at the time of operation.
2. The highest positive rate of this lymphatic metastasis was observd on the cancers formed on the gastric horn (6, 7) of the lesser curvature, cardiac region (e), pylous (2, 4) and the greater curvature (0, 1) .
3. No appreciable parallelism was observed between the positive rate of lymphatic metastasis and the size or the macroscopic type of the cancer.
4. It paralleled well, however, with the penerability of cancer cells into the gastric wall.
5. As for the relationship between the histological types of cancer and the positive rate of lymphatic metastasis, the rate was high in the order listed: colloid cancer, medullary canncerr, withering cancer and the cancer of the mixed type.
6. Prognosis of the patient is dependent on the penerability of the cancer cells into the gastric wall, positive rate of lymphatic metastasis and the local findings of the cancer cell foci.
7. Of autopsy findings of recurrent cases, local recurrence were seen in a high percentage indicating the necessity of extensive exision and combined excision.
8. Most cases of the metastasis into the visceral parenchyma were the cases of adenocarcinoma. On the contrary, withering cancer was proved to be characterized by continuous infiltration. These findings are important for the selection of the techniques to be employed at the time of operations.
