Prognosis and surgical treatment of gastric cancer invading the pancreas

The clinicopathologic characteristics of gastric cancer invading the pancre as have not been determined. Gastrectomy was performed in 282 patients with gastric cancer invading adjacent organs at the Department of Surgery II, K yushu University Hospital, between 1970 and 1987, and patient data were ret rospectively analyzed using univariate and multivariate analyses. Of these patients, 150 (53.2%) had tumors invading the pancreas and 132 had tumors i nvading adjacent organs other than the pancreas. In both groups, the undiff erentiated tissue type with infiltrative growth, lymphatic involvement and lymph node metastasis was common. In cases of pancreas invasion, the extent of lymph node metastasis was more severe, vascular involvement was more fr equent and the rate of concomitant liver metastasis was higher. The surviva l time of the patients with pancreas invasion was shorter compared to patie nts with cancer invading other organs, and pancreas involvement was one of the independent factors predicting a poor prognosis. With respect to surgic al treatment of gastric cancer invading the pancreas, the prognosis was bet ter for cases treated with curative surgery and pancreas resection. Of 39 p atients treated with partial resection of the pancreas, the tumor had invad ed only the capsule of the pancreas in 18 and the pancreas in the other 21. Pancreas-invasive gastric cancer cells are likely to advance via lymphatic and vascular routes and survival time is shorter, but curative resection c an improve the survival rate, and perioperative treatment should be appropr iately designed. Copyright (C) 2000 S. Karger AG, Basel.