This report covers the period of 6 years(Jan. 1981~Dec. 1986) in the field of stomach cancer at Maryknoll hospital surgery surgery department. Of 281 patients operated on for stomach cancer 220 underwent curative operations and of these we
conducted a
follow up program for 200 patients; the others underwent palliative operations after which we did a follow up program for them.
@ES Below we give the results of our investigation:
@EN 1) Those above 50 years of age 28.8% were the majority and those under 30 years old(7.1%) were the least in number. By sex, males had a higher ration than females by 1.96 to one.
2) The 5 year survival rate for the patients of 30 years to 59 years of age and the survival rate of those under 30 years old and above 60 years old was 37.3%, 56.8% respectively.
3) By sex, the 5 year survival rate of males and females was 45.6%, 56% respectively.
4) By the duration of symptoms, those below 1 month(27.4%) were the majority and those to 2 years, 5.7% were the least in number. The 5 year survival rate of those with the duration of symptoms for 1 to 3 months(57.1%) was the longest period and
that
of those for 1 to 2 years(36.4%) was 54.8% and that of patients above 3 months was 44.8%.
5) The number of patients with postoperative complications was 40(14.2%) and pulmonary complications were the most common. The postoperative in patient mortality was 2.8%.
6) By the location of a main tumor, the antrum(68.7%) were the majority and the diffuse type (1%) were the antrum(52.5%) was the longest and that of those of the fundus and cardia(33.3%) was the shortest period; that of those of the fundus and
cardia,
diffuse type considered as poor prognosis, was 37.5%; that of those of the antrum and body was 50%.
7) By the size of tumor, 2 to 5 cm(52.7%) were the majority and under 2 cm (18.9%) were the lest number. The 5 year survival rate of those with the size of a tumor under 2 cm was 73.7% and that of patients above 2 cm was 43.5%.
8) By the stage of cancer, stage III(32%) were the majority and stage I(16%) were the least in number. The 5 year survival rate of those of stage I(92.5%) was the longest and that of the patients of stage IV925) was the shortest period.
9) By histopathologic analysis
(a) By classification according to The Japanese Research Society for Stomach Cancer, the tubular adenocarcinoma(42.7%) were the majority and the papillary adenocarcinoma(6.4%) were the least in number. The 5 year survival rate of those with
tubular
adenocarcinoma(62.9%) was the longest period and that of those with poorly differentiated adenocrcinoma(44.2%) was the shortest period; the rate of patietns with tubular & papillary adenocarcinoma was 60.8% and that of those with poorly
differentiated
and signet ring cell and mucinous adenocarcinoma was 47.9%.
(b) By a Lauren's classification, the intestinal type was 40.4% and the diffuse type were 59.6% in number, and the 5 year survival rate of those with the intestinal type was 59.3% and the rate of those with the diffuse type was 51.1%.
(c) By using the degrees of the lymphocytic infiltration, None(60.2%) was the majority and Moderate, Severe, 5%, 3ach were the least in number. The 5 year survival rate of those with Severe and Moderate was 70% and that of those with None &
Slight
was
53%.
10) The rate of curative operations was 78.6%(220/281), and in the curative operation group, subtotal gastrectomies(90%) were the majority. Extended subtotal gastrectomy(0.4%) was the least in number and the 5 year survival rate of those with
the
curative operations was 49.6%, that of those with subtotal gastrectomies was 50.8% and the rate of these with total gastrectomies was 38.5%.
11) Among the 63 patients who underwent palliative operations, the resectable group was 22.2% and the unresectable group was 74.6%. Among the 54 patients(85.7%) of whom a follow up program was conducted, the 6 months survival rate of the
patients
who
were resectable and not resectable was 78.6%, 52.5% respectively, and the 1 year survival rate of these was 50%, 10% respectively, and the mean survival time of them was 16.85 months, 7.18 months respectively.
|