The prognosis of carcinoma of the stomach depends on the extent of penetration of the wall by the tumor and involvement of adjacent organ. Actually serosal invasion is an important prognostic factor of survival of the gastric cancer surgery.
However
covering gastric ligaments or omenta obscures not only the classification the serosal involvements but also the concepts of cancer spread.
We examined distribution of stage, lymph node metastasis, presence of intraperitoneal free cancer cells, gross morphology of cancer, pathologic type, size of tumor, and survival rate of T3NOMO cases using the 179 omental invasion cases and 26
serosal
invasion only cases collected among the 331 gastric cancer resection during 4 years(1987-1990) in NMC.
In pateints with omental invasion, stage IV was 44.7%, n2 lymph node metastasis was 31.8%, presence of intraperitoneal free cancer cells was 16.8%, and 8.1~12cm sized tumor was 40.8%. In patients with serosal invasion only, stage II was 46.2%, n0
lymph
node metastasis was 46.2%, presence of intraperitenceal free cancer cells was 3.9%, and 4.1~8.0cm sized tumor was 50.0%.
Survival study of T3NOMO cases was 77.9% in patients with omental, whereas the survival study was 88.9% in patients with serosal invasion only, but there was no statistical significance.
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