Surgery of gastric cancer in patients over 80 years old.

A retrospective study on postoperative complications and factors affecting prognosis was performed on elderly patients with gastric cancer. We studied the correlation of age, pathological depth, preoperative laboratory data, physical status, duration of surgery, volume of blood loss, blood transfusion, curability, and extent of lymph node dissection to postoperative complications and prognosis in 47 patients with gastric cancer over 80 years old. Preoperative function of lung and liver frequently showed abnormal data. Postoperative complications were noted in 47% of patients, especially in the pulmonary system, liver and heart. Curability and extent of lymph node dissection were the significant factor affecting survival. Some mortalities caused by initial malignancy were recognized in the conservative lymph node dissection in the stage I. The incidence of postoperative complications was not significantly different according to extent of lymph node dissection. Blood transfusion was the only significant factor for the incidence of postoperative complication. The most frequent cause of death was the initial malignancy. We recommend that a low grade lymph node dissection should not be readily chosen for elderly patients in early cases.

[A case of inflammatory breast cancer well treated with intraarterial infusion chemotherapy-- evaluation of therapy by contact thermography].

A case of inflammatory breast cancer, for which an intra-arterial infusion chemotherapy was reported that it was effective. A 63 year-old woman was admitted with the complaint of left breast mass and reddish skin. Clinically it was diagnosed to be inflammatory breast cancer and was treated with an intra-arterial infusion. Contact thermography was employed for the efficacy of the treatment. Three weeks after the chemotherapy the temperature of the tumor site was decreased with a reduction of the tumor size. But, the opposite symptoms appeared before the tum or size increased. Contact thermography seemed to be useful for an evaluation of the preoperative chemotherapy for inflammatory breast cancer.

[The effect of intraperitoneal and intra-aortic chemotherapy for unresectable gastric cancer].

Regional chemotherapy was given 16 unresectable gastric cancer patients. Two types of the chemotherapy, intraperitoneal (IP) and intraaortic (IA) administration, were carried out. The control group was comprised of 17 patients. The response of the chemotherapy for primary tumor was 36.4% in the IP group and 20% in the IA one. Among these patients, 2 of 11 in IP and 1 of 5 in IA were able to resect the primary tumor. The 50% survival time of IP, IA and control was 347, 227 and 78 days, respectively. One-year survival rates of IP, IA and control were 68%, 29% and 0%, respectively. IP showed a significantly longer survival rate than controls (p < 0.001). All but one patient was able to stay at home. Intraperitoneal chemotherapy showed both local and systemic effects in unresectable gastric cancer.

[Effect of intraperitoneal chemotherapy with implantable reservoir against unresectable gastric cancer].

Intraperitoneal chemotherapy was applied for eight unresectable gastric cancer patients, including two exploratory laparotomy and six gastrojejunostomy. Chemotherapeutic agents were given ip at a dose of 75 mg/body of cisplatin and 150 mg/body etoposide and iv at a dose of 10 mg/body of mitomycin C as well as orally 5-FU. This treatment was repeated three to ten times. An overall response rate against primary lesion was 40%. Six month and 1 year survival rate of this therapy were 87.5% and 75% respectively, while those of control group were 42% and 0%. Median duration of survival was 518 days in this chemotherapy group and 172 days in the control. In this study, intraperitoneal chemotherapy group showed a significant improvement of survival compared to the control. All patients were able to stay home between therapies. This method seemed to be beneficial to the unresectable gastric cancer patients.

[Evaluation of hepatic arterial infusion chemotherapy for gastric cancer].

Hepatic arterial infusion chemotherapy (HAIC) using implantable reservoir was performed for liver metastases of gastric cancer and the therapeutic effects were evaluated. A catheter was placed in the hepatic artery via left subclavian artery or by direct insertion at laparotomy. Cisplatin, adriamycin and 5-FU were administered. The liver metastases of gastric cancer without unresectable primary tumors and hepatectomy were divided into two groups, 16 HAIC cases (11 synchronous, 5 metachronous metastases) and 23 systemic chemotherapeutic cases (10 synchronous, 13 metachronous metastases). As a result, HAIC revealed a 62.5% response rate. The 50% survival period was 395 days for HAIC, and it was significantly prolonged compared with 198 days for systemic chemotherapy (p < 0.01). But 4 among 10 cases responding to HAIC showed subsequent extrahepatic spread of the disease. Treatment of these extra-hepatic lesions is difficult.

[A case of cystadenocarcinoma of the liver complicated by gastric cancer--a review of 83 cases of primary cystic liver cancer in the literature].

So far as is known, this is the first reported case in the literature of a primary cystic liver cancer complicated with a gastric cancer. A 77-year-old female was admitted to hospital because of a swelling in the upper abdomen and appetite loss. CT scanning, an echogram, and an angiogram of the abdomen revealed a large cystic lesion which originated from the left lobe of the liver. A DIC indicated a gall stone, Further, upper GI fluoroscopy and endoscopy revealed a gastric cancer of the Borrmann II type, and thus a dome resection of the cyst, cholecystectomy, aad 3/4 partial gastrectomy was performed. The liver was found to contain much mucin. The histology indicated a cystadenocarcinoma of the liver, and an adenocarcinoma of the stomach of a poorly differentiated type.