Gastric carcinoma invading muscularis propria and macroscopic appearance

From 1965 to 1983, 1362 patients with primary gastric cancer and no other evidence of a malignancy underwent gastric resection in the Second Department of Surgery, Kyushu University. Of these, 117 patients (8.6%) with gastric cancer invading the muscularis propria (pm) were studied clinicopathologically with special reference to the macroscopic appearance: Borrmann type cancer or advanced gastric cancer simulating early gastric cancer (AGC simulating EGC). The Borrmann type cancer comprised 62.4% (73/117) of cases and the AGC simulating EGC comprised 37.6% (44/117). The survival rate for patients with the Borrmann type cancer was lower than in cases of AGC simulating EGC (P < 0.01). The 10-year survival rate was 82.6% for patients with AGC simulating EGC and 60.5% for those with Borrmann type cancer. A multivariate analysis showed that operative curability and lymph node metastasis are significant prognostic factors and these events differed between the Borrmann type cancer and AGC simulating EGC and the survival rate for patients with the Borrmann type cancer was less favorable. Our findings show that the lymph node dissection is important for the operative curability of pm gastric cancer with the Borrmann type. Postoperative chemotherapy is required in cases of a non-curative resection.