Abstract
Effectiveness of prophylactic extensive lymph node dissection (PELD) plus postoperative long term combination chemotherapy (PLCC) for patients with curatively resected gastric carcinoma was assessed in terms of the degree of serosal invasion and lymph node metastasis. Either the Group 1 and Group 2 lymphnodes were eradicated by PELD. PLCC included intermittent intravenous administration of mitomycin C (0.4 mg/kg intraoperatively followed by 0.2 mg/kg every 3 months) and oral administration of Tegafur (600–800 mg/day) and PSK (3.0 g/day), an immunostimulator, for as long a period as possible. PELD alone resulted in a cure when the malignancy was confined to the mucosal and muscular layers of the stomach as well as to the Group 1 lymph nodes. In cases when the carcinoma involved the serosa and/or the Group 2 lymph nodes, the 5 year survival rate was about 55 per cent the PELD and PLCC groups, such being significantly higher than about 27 per cent in the PELD alone group. Therefore, PELD plus PLCC is highly effective for advanced gastric carcinoma, under a condition of curative resection.
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Jinnai, D.: Evaluation of extended radical operation for gastric cancer, with regard to lymph node metastasis and follow up results. Gann 3: 225–231, 1968.
Mine, M., Majima, S., Harada, M., and Etani, S.: End results of gastrectomy for gastric cancer. Effect of extensive lymph node dissection. Surgery 68: 753–758, 1970.
Soga, J., Kobayashi, K., Saito, J., Fujimaki, M., and Muto, T.: The role of lymphadenectomy in curative surgery for gastric cancer. World. J. Surg. 3: 701–708, 1979.
Kodama, Y., Sugimachi, K., Soejima, K., Matsusaka, T. and Inokuchi, K.: Evaluation of extensive lymph node dissection for carcinoma of the stomach. World. J. Surg. 5: 241–248, 1981.
Veterans Administration Surgical Adjuvant Study Group.: Use of thio-TEPA as an adjuvant to the surgical management of carcinoma of the stomach. Cancer 18: 291–297, 1965.
Serlin, O., Wolkoff, J.S., Amadeo, J.M., and Keehn, R.J.: Use of 5-fluorodeoxyoridine (FUDR) as an adjuvant to the surgical management of carcinoma of the stomach. Cancer 24: 223–228, 1969.
Huguir, M., Destroyes, J.P., Baschet, C., Henand, F.L., and Bernard, P.F.: Gastric carcinoma treated by chemotherapy after resection. A controlled study. Am. J. Surg. 139: 197–199, 1980.
Hattori, T., Mori, A., Hirata, K., and Ito, I.: Five year survival rate of gastric cancer patients treated by gastrectomy, large dose of mitomycin C, and/or allogeneic bone marrow transplantation. Gann 63: 517–522, 1972.
Kaibara, N., Soejima, K., Nakamura, T., and Inokuchi, K.: Postoperative long term chemotherapy for advanced gastric cancer. Jpn. J. Surg. 6: 54–59, 1976.
Japanese Research Society for Gastric Cancer.: The General Rulse for Gastric Cancer Study in Surgery and Pathology. Jpn. J. Surg. 11: 127–129, 1981.
Miwa, K.: Cancer of the stomach in Japan. Gann 22: 61–75, 1981.
Adashek, K., Sanger, J., and Longmire, W.P.Jr.: Carcinoma of the stomach. Review of consecutive ten-year intervals. Ann. Surg. 189: 6–10, 1979.
Buchholz, T.W., Welch, C.E., and Malt, R.A.: Clinical correlates of resectability and survival in gastric carcinoma. Ann. Surg. 188: 711–715, 1978.
Dupont, J.B. Jr., Lee, J.R., Burton, G.R., and Cohn, I. Jr.: Adenocarcinoma of the stomach. Review of 1497 cases. Cancer 41: 941–947, 1978.
Ochsner, A., Weed, T.E., Nuessle, W.R.: Cancer of the stomach. Am. J. Surg. 41: 10–14, 1981.
Schabel, F.M.: The use of tumor growth kinetics in planning “Curative” chemotherapy of advanced solid tumors. Cancer Res. 29: 2384–2389, 1969.
Nomoto, K., Yoshikumi, K., Matsunaga, K., Fujita, T., and Takeya, K.: Restoration of antibody-forming capacities by PSK in tumor bearing mice. Gann 66: 365–374, 1975.
Fujimoto, S., Akao, T., Itoh, B., Koshizuka, I., Koyano, K., Kitsukawa, Y., Takahashi, M., Minami, T., Ishigami, H., Kure, M., Itoh, K., and Hirosaka, T.: Protracted oral chemotherapy with fluorinated pyrimidines as an adjuvant to surgical treatment for stomach cancer. Ann. Surg. 185: 462–466, 1977.
Hattori, T., Niimoto, M., Koh, T., Nakano, A., Oride, M., Takiyama, W., and Nishimawari, K.: Postoperative long term adjuvant immunochemotherapy with mitomycin C, PSK and FT-207 in gastric cancer patients. Jpn. J. Surg. 9: 110–117, 1979.
Kano, T., Kumashiro, R., Tamada, R., Kodama, Y., Inokuchi, K.: Late results of postoperative long term cancer chemotherapy for advanced carcinoma of the stomach. Jpn. J. Surg. 11: 291–296, 1981.
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Kodama, Y., Kano, T., Tamada, R. et al. Combined effect of prophylactic lymphadenectomy and long term combination chemotherapy for curatively resected carcinoma of the stomach. The Japanese Journal of Surgery 12, 244–248 (1982). https://doi.org/10.1007/BF02469555
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DOI: https://doi.org/10.1007/BF02469555