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Late Recurrence of Gastric Carcinoma: From clinicopathological point of view T. Iwanaga 1 , H. Tanaka 1 , H. Koyama 1 , H. Furukawa 1 1Dept. of Surgery, The Center for Adult Diseases pp.21-31
Published Date 1977/1/25
DOI https://doi.org/10.11477/mf.1403112413
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 The rate of recurrence more than five years postoperatively was 4.5% among 242 patients who received radical resection for gastric carcinoma more than ten years previously. Twentyfive patients with late recurrence (more than five years postoperatively) were compared with 129 patients with early recurrence (within two years) and 116 long term survivors (surviving more than ten years).

 In regard to stages of gastric carcinoma at the initial operation, early cancer was mostly seen in long survivors and advanced cancer often developed early recurrence. There was no specific stage that developed late recurrence frequently. However, the percentage of early gastric cancer in the late recurrence group was definitely higher than that in the early recurrence group. Late recurrence cases were intermediately situated between early recurrence cases and long survivors in respect to the macroscopic type of the primary lesion, the extent of lymphatic involvement and the degree of stromal reaction. Local and peritoneal involvement was most often seen in early recurrence cases, and recurrence of the remnant stomach or stump was observed in a relatively high rate of late recurrence cases. It was also characteristic to late recurrence that scirrhous infiltration type of peritoneal involvement was found almost exclusively in this group.

 We assume that the following four conditions would be necessary for late recurrence: (1) cancer cells left at the time of operation should be small in number; (2) remaining cancer cells should be disadvantageously located for spread; (3) proliferation of cancer be slow; (4) host resistance be active. We often found findings suggestive of the above conditions in our late recurrence cases. Contageous infiltration and lymphatic involvement seemed to be the origin of late recurrence.

 Further development in surgical procedures and supplementary therapeutic measures such as chemotherapy and immunotherapy are expected to decrease the late recurrence, and to improve the follow up results of gastric cancer.


Copyright © 1977, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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