Abstract
Cancer of the stomach (CaS) is a dreaded disease. Fortunately, there is a decreasing incidence, except in the East. The authors did a re-study of CaS, a widely investigated but unresolved gastrointestinal malignancy. The clinicopathologic features were evaluated to identify and measure the prognostic factors that would help the surgeon decide optimal therapy. Among 383 admitted for CaS at the East Avenue Medical Center, Quezon City, Philippines between January 1987 and December 1996, 149 underwent radical resection with curative intent. (As historical control, the experience in 136 cases was reviewed during the immediately preceding 5-year period [1982-1986] when extended lymphadenectomy was not the standard policy.) For staging, the TNM system (tumor-node-metastasis) was used; to describe anatomy and surgery of stomach lymphatics, the "Japanese Rules," as modified, were adapted. Curative radical gastrectomy would include removal of the diseased stomach and regional lymphatics as defined by frozen section, including subtotal (or total) gastrectomy and "extended" D2 (with no. 12) node dissection. The clinicopathologic factors were statistically analyzed, using the accepted methods: Kaplan-Meier for survival, univariate analysis,...Continue Reading
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