The concept of gastric ulcerocancer has already been established by Hauser. The author's colleagus Nakamura tried to expand the criteria of this ulcerocancer. He could select 126 cases of ulcerocancer out of the 512 cases of gastric cancer received excision during the past 7 years in the Second Department of Surgery, Tokyo University School of Medicine.
This author undertook the clinical investigation of these 126 cases of ulcerocancer and statistic observations were made on their symptoms and prognosis. As controls, clinical findings of the 60 cases of round ulcer and 100 cases of non-ulcerative cancer were employed for comparison. The results obtained were as follows :
1. Male and female ratio of ulcerocancer was 2.5 : 1. Patients at the age of fifties were predominant. But there were a number of cases developed in relatively young age groups. Period of suffering was intermediate between gastric ulcer and gastric cancer.
2. As for the clinical symptoms from the time of onset to that of operation, most of the patients suffered from epigastric pain in an early stage gradually developing the symptoms of stenosis. Namely, at the time of onset, the symptoms of ulcerocancer resemble to the symptoms of gastric ulcer and when advanced, necessitating surgical operation, they become nearly the same as the symptoms of gastric cancer.
3. In an early stage, most of the patients showed the hyperacidity of gastric juice, but when advanced they showed hypoacidity.
4. In an early stage, diagnosis by X-ray is highly difficult. In contrast to the high rate of the detection of nische, some cases are deficient of the shadow and, moreover, the rate of palpable tumor is low at the time of fluoroscopy leading to the erronious diagnosis of gastric ulcer.
5. The site of predirection is the pyloric region and the lesser curvature. In most cases, , they are less than 5 cm in diameter. Spread to the surrounding organs at the time of operation was recognized in 55% and swelling of the regional lymphnodes was recognized in 76%.
6. As for macroscopical classification, 23% were Borrmann's type II and 77% were type III. Histologically, 61% were adenocarcinoma and 39% were solid cancer. Type C of C, P, L classification was small in number. Advanced cases of types P and L were also few.
7. As prognosis of the patients received surgical operation, the survival rate for 3 years was 42% and for 5 years 32%.
8. C, P, L classification agreed well with the prognosis of surgical operation.
9. Nakamura's classification of I, II and III based on the intensity of cancerous infiltration in the periphery and at the base of the ulcerative cancer also agreed well with the prognosis of the patients.
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