CLINICOPATHOLOGICAL STUDY OF PATIENTS WITH BORRMANN TYPE-IV GASTRIC-CARCINOMA

Between 1979 and 1993, 665 Japanese patients with advanced gastric can cer underwent surgery at our hospital. These patients were divided int o two groups, consisting of 102 patients with Borrmann type IV carcino ma, and the remaining 563 patients with all other types of gastric car cinoma, which were then compared clinicopathologically. In the patient s with Borrmann type IV carcinoma, 77.4% of the lesions demonstrated p oorly differentiated adenocarcinoma, and 99 patients were classified a s Stage III or IV. The resection rate was 87.2% (89/102) with only 39 curative operations despite the fact that 70 total gastrectomies were performed. The incidence of peritoneal dissemination (29.4%) and seros al invasion (97.0%) was significantly higher in these patients. Micros copic lymph node metastasis was positive in 86.5%. The 5-year survival rate was 23.4% in the patients with a curative operation and 5.0% in those with a noncurative operation (p < 0.01). Peritoneal disseminatio n was most frequently noted in the recurrence patterns. We conclude th at early detection and a curative operation are both essential to impr ove the prognosis of patients with Borrmann type IV gastric cancer. Th e addition of a potent postoperative chemotherapy regimen is also reco mmended. (C) 1995 Wiley-Liss, Inc.