Significance of surgical treatment for stage Ⅳ gastric cancer

過去22年間のStage Ⅳ切除胃癌320例について予後の面より検討を加え以下の結果を得た．胃癌取扱い規約による規定因子は単因子が40.6％を占め，遠隔成績ではS，P，N，Hの順に予後は良好であった．2因子ではSP，SN，HN，PN，SHの順であり，3因子間には差は認めなかった．断端遺残を加えた非治癒因子数では，1個のもの（35.3％）は2個以上のものに比べ有意に良好であった．治癒切除は7.8％に行われたが，絶対非治癒243例の平均生存日数は293日で不良であった．切除例では非切除胃癌と比べ有意に良好であった．切除術式では部分切除が不良であったほかには差は認めなかった．以上よりStage Ⅳ胃癌のうち予後不良群として亜分類するとすれば，n4，P2-3，H1-3の各因子をもつものである．For 320 cases of stage IV gastric cancer operated on at the First Department of Surgery, Nagasaki University during a period of 22 years from 1969 to 1990, the stage IV factors as defined by General Rules for Gastric Cancer stage were divided into groups and late results of operation were mainly studied to obtain results as followed. Cases of stage IV gastric cancer accounted for 30.6% of the cases of gastric cancer subjected to laparotomy and for 23.2% of the cases of gastric cancer treated by resection. By curatice operation, the cases were broken down to absolute cure 11 cases, relative cure 14 cases, relative non-cure 49 cases and absolute non-cure 243 cases. The mean number of days of survival after operation was 1222, 686, 897 and 293 days respectively, there being a significant difference (pSH (p