ABSTRACT
The expression of epidermal growth factor (EGF) was immuno-histochemically examined in the primary lesions of 201 patients with advanced gastric cancer who underwent curative resection. EGF-positive tumor cells were detected in the specimens of 75 patients (37.3%). A significant correlation was observed between the extent of lymph node metastasis and EGF expression (p < 0.01), indicating that EGF-positive cancer has a tendency to lymph node metastasis. The 2-year and 5-year survival rates of the patients with EGF-negative tumors were 77.2% and 63.0%, respectively, while those with EGF-positive tumors were 59.1% and 47.5% respectively. The difference in survival rates reached a maximum 2 years after surgery, indicating that the patients with EGF-positive gastric cancer had a higher risk of early recurrence. Therefore, the amount of EGF produced by a tumor may play some role in the growth of metastatic tumors and residual tumor cells after surgery, and thus be a potential risk factor in recurrence.
Subject(s)
Adenocarcinoma/metabolism , Biomarkers, Tumor/biosynthesis , Epidermal Growth Factor/biosynthesis , Neoplasm Recurrence, Local/metabolism , Stomach Neoplasms/metabolism , Adenocarcinoma/mortality , Adenocarcinoma/pathology , Adenocarcinoma/secondary , Adenocarcinoma/surgery , Follow-Up Studies , Humans , Lymphatic Metastasis , Neoplasm Invasiveness , Neoplasm Recurrence, Local/mortality , Neoplasm Recurrence, Local/pathology , Postoperative Period , Risk Factors , Stomach Neoplasms/mortality , Stomach Neoplasms/pathology , Stomach Neoplasms/surgery , Survival Rate , Time FactorsABSTRACT
Data on 29 patients with primary gastric lymphoma and on 1655 with gastric carcinoma were compared with respect to the local extension and the results of surgery. More than two-thirds of the gastric area was involved due to multiple or widespread lesion in 25.9% and 7.0% of the patients with gastric lymphoma and carcinoma, respectively. Maximum tumor dimension exceeded 10 cm in 33.3% and 9.5% of gastric lymphomas and carcinomas respectively. Involvement of the extra-perigastric lymph nodes was evident in 51.8% and 26.2% of the patients with gastric lymphoma and carcinoma respectively. Therefore, wide and extended resection, including total gastrectomy, would be required more often for the surgical excision of gastric lymphoma. Peritoneal dissemination and liver metastasis were much less common in those patients with gastric lymphoma and hence, benefiting most from surgery. The five year survival rate after curative resection was somewhat better in patients with a gastric lymphoma (79.3% as compared to 65.6%), whereas the prognosis after non-curative surgery was equally unfavorable. Aggressive surgical excision is thus recommended for the treatment of patients with a primary gastric lymphoma.
Subject(s)
Carcinoma/surgery , Gastrectomy/methods , Lymphoma/surgery , Stomach Neoplasms/surgery , Carcinoma/mortality , Carcinoma/pathology , Gastrectomy/mortality , Gastrectomy/statistics & numerical data , Humans , Japan/epidemiology , Life Tables , Lymphatic Metastasis , Lymphoma/mortality , Lymphoma/pathology , Neoplasm Invasiveness , Palliative Care , Stomach Neoplasms/mortality , Stomach Neoplasms/pathology , Survival RateABSTRACT
Two patients with recurrent gastrointestinal carcinoma were treated with THP. Partial response was recognized in the local recurrent tumor of one patient and in liver metastasis of a second patient. THP was administered every three weeks at a dose of 60 mg per total body weight intravenously. The total dose of THP achieved was 720 mg in the first patient and 920 mg in the second. Despite the high dosage, neither cardiotoxicity nor alopecia was observed. These results suggest that the administration of THP may be efficacious and safe in the management of patients with recurrent gastrointestinal carcinoma.