Abstract
With the aim of obtaining effective concentration of antitumor agents in the regional lymph nodes of the stomach, 1) local injection of antitumor agent, 2) ligation of the gastric veins and 3) combined use of dextran sulphate (DS) and urokinase (UK) were performed, and it was examined whether these methods were useful for treatment and prevention of metastases from the view point of tissue level of the agents in the lymph nodes. The subjects examined were 120 cases of gastric Cancer, in which concentration-dependent antitumor agents such as Mitomycin C (MMC) or Cyclophosphamide (CPA) were injected into the gastric wall adjacent to the carcinoma just after laparotomy. After extirpation of the regional lymph nodes and resection of the stomach, the concentration of antitumor agents was measured. The concentration of agents in the regional lymph nodes after local injection of 500 mg of CPA was approximately two times higher in both direct and indirect values than those after intravenous injection. By a local injection of 10 mg of MMC, effective concentration of MMC was detected in the groups 1 and 2 regional lymph nodes of the stomach as well as at the surgical margins of resection. Although the concentration of agents in the lymph nodes containing metastatic carcinoma was lower than that in the normal nodes, ligation of the efferent gastric veins caused 1.5-2.5 times increase in concentration. Moreover, combined use of DS and UK with antitumor agents before the surgical operation increased the tissue level of antitumor agents regardless of metastases in the lymph nodes.
