Thirty-five cases of gastric cancer were analyzed for the purpose of improving surgical result at the Department of Surgery, College of Medicine, Korea University, during 23 months from Jan. 1, 1975 to Aug. 31, 1976.
Following results were obtained:
1. During this period the incidence of gastric cancer was 3. 6% among all surgical cases admitted to the Department of surgery.
.2. The peak incidence was in the aged group between 50~´59 years, mounting to 14 cases (40 % ).
The ratio of Male to Female was 2.2: 1, outnumbering in male.
3. The rate of diagnostic.accuracy of X-ray study was 91.4% in gastric cancer.
In 35 patients, 12 patients had endoscopic examination and the rate of diagnostic accuracy was 91.7%.
4. Location of gastric cancer:
In 35 gastric cancers there were 6 cases of far advanced gastric, cancer the primary location of which could not be confirmed.
In remaining 29 cases, there were 15 cases (51.6%) involving antrum and 10 cases (34.4%) involving both antrum and body.
5. Macroscopic classification of gastric cancer:
In 29 cases of resected gastric cancer, there were 3 cases of early gastric cancer and 26 cases of advanced gastric cancer according to definition of Japaness Society for Gastro-enterological Endoscopy.
a) All 3 cases of early gastric cancer belong to Type II c.
b) Twelve cases were classified as Borromann Type III; 11 cases as classified-Borrmann. Type V and 3 cases as Borrmann Type II
6. Twenty seven cases out of 29 resected cases were treated with radical subtotal gastrectomy and 2 cases were treated with total gastrectomy.
7. In 29 resented cases of gastric cancer, there were 11 cases of gross serosal invasion. 8. Macroscopic classification of the extent of spreading to the peritoneum:
There were 14 cases of no dissemination to peritoneum and 14 cases of dissemination to adjacent peritoneum without distant metastasis.
There were no cases of gross liver metastasis in resected gastric cancer.
9. Classification of the degree of lymph nodes metastasis under the microscopic finding:
In 29 resected cases of gastric cancer, there were 20 cases of metastasis to infrapyloric lymph node and 19 cases of metastasis to suprapyloric lymph node.
10. Classification of gastric resection based on the degree of lymph node removal:
In 29 resectable cases, 27 cases (93.1%) belong to R2 (gastric resection with the removal of lymph nodes of the group 1 and 2) and 2 cases (6.9%) belong to Rl (gastric resection with the removal of lymph nodes of the group I only).
11. The determination of the existence of cancer infiltration along the cut margins of the resected stomach under microscopic examination:
In 29 resected cases, cut margins of cephalipedal site in 12 cases (41.4%) were involved with cancer cell, and those of caudipedal site in 4 cases (41.4%) were involved with cancer cell.
12. Curative resection versus Non-curative resection:
In 29 resected cases, there were 11 cases (37.9%) of absolute non-curative resection, 6 cases (20.7%) of absolute curative resection, 6 cases (20. 7%) of absolute curative resection, 6 cases (20.7%) of relative curative resection and 6 cases of relative non-curative resection.
13. Follow up study:
In 29 resected cases, 20 (69.3%) patients were followed up from 3 month to 1 year, and missed follow up in 9 patients (31,7%).
In 20 patients of follow-up, 1 patient died of leakage at gastrojejunostomy 14 days postoperatively and 1 patient died of metastasis 7 months postoperatively. The remaining 18 patients are alive well.
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