CANCER OF THE STOMACH - A REVIEW OF 2 HOSPITALS IN KOREA AND JAPAN

The records of 525 patients with primary adenocarcinoma of the stomach treated at Korea University Hospital (K.U.H.), Seoul, Korea, and 1,93 2 patients treated at National Cancer Center Hospital (N.C.C.), Tokyo, Japan, over a 7-year period were reviewed to study biologic character istics and treatment results in the two hospitals. More than 70% of th e patients were 41 to 70 years old in both hospitals, though K.U.H. ha d more younger patients and N.C.C. had more older patients. Comparison in regard to clinicopathologic features showed significant difference s in type of cancer, tumor size, depth of invasion, lymph node metasta sis, stage, and histologic type. Such a difference mostly was due to a greater frequency of early gastric cancer in N.C.C. patients (51.2%) than in K.U.H. patients (19.0%). Patients of K.U.H. were more likely t o have advanced cancer, large invasive tumors, a higher percentage of lymph node metastasis, a higher stage, and more undifferentiated tumor s. The 5-year survival rate of all resected cases was 69.5% in N.C.C. and 54.2% in K.U.H. (p > 0.05). Those factors which showed a significa nt difference in clinicopathologic features did not affect the surviva l difference between the two hospitals except in stage IIIb and signet -ring-cell cancer. The 5-year survival rate for stage IIIb was 18.0% i n K.U.H. and 36.8% in N.C.C. It would seem that survival difference in stage IIIb related to extensive lymph node dissection in N.C.C. Survi val difference in signet-ring-cell gastric cancer (31.2% in K.U.H. and 91.0% in N.C.C.) was related to the fact that 79.1 % of signet-ring-c ell gastric cancer patients in N.C.C. had early gastric cancer. This p resent study once again demonstrates the importance of early detection in the treatment of gastric cancer and suggests that gastric cancer o f two countries is not different.