SURGICAL-TREATMENT OF PATIENTS WITH GASTRIC-CARCINOMA AND DUODENAL INVASION

We retrospectively examined the extent of invasion of gastric cancer w ith duodenal involvement in order to design pertinent surgical procedu res that may lead to a better prognosis. Examinations were made on exc ised tissues from 650 patients who underwent gastrectomy for adenocarc inoma in the gastric antrum. In 95 patients, the cancer cells extended to beyond the pyloric ring, Spread into the duodenum was limited to w ithin 2 cm in 76% of the patients and to within 3 cm in 81%. In additi on to high rates of metastasis in group 1 and 2 lymph nodes, some grou p 3 lymph nodes also were involved, and more frequently so in cases wi th duodenal invasion than in those without such invasion (P < 0.01). T he 5-year survival rate for patients with duodenal invasion was 35.4% when a curative resection was done. For patients with advanced adenoca rcinoma with duodenal invasion, gastrectomy with resection of 3-4 cm o f the duodenum and dissection of group 1, 2, and 3 lymph nodes were re commended. (C) 1995 Wiley-Liss, Inc.