[Treatment methods for scirrhous carcinoma of the stomach--with special reference to total gastrectomy and chemotherapy in early postoperative period].

The problems existing in surgical treatment methods for scirrhous carcinoma of the stomach include the following: (1) highly advanced cases are frequent, (2) remnants of carcinoma in the proximal line of resection is frequent, and (3) peritoneal dissemination is frequent. Investigations were made on 76 cases of scirrhous carcinoma of the stomach in the care of our department, and the treatment methods in these cases were as follows: 1) Lymph node dissection: Lymphadenectomy of over R2 is performed. 2) Operative methods: When the cancer lesion is in A, AM, M, or MA, and when the proximal line of resection can be made in the excess of 5 cm from the tumor margin, than a sub-total gastrectomy is performed. For cancer lesions in areas other than the above, and for cancer lesions in the above but when the OW cannot be made to measure over 5 cm, a total gastrectomy is performed. In cases in which the cancer invasion extends beyond EGJ and when non-curative resection factors are absent, then an abdomino-thoracic approach is adopted. 3) Chemotherapy: There was some efficacy among the curative resected cases. Since most of the cases result in peritoneal dissemination, chemotherapy is applied during operation and during the early postoperative period.