Appendix: Tabular Analysis ofCIH (Cancer Institute ...978-4-431-67927-1/1.pdftumor characteristics based on operative findings and histopathological study, and clinical stages according

Appendix: Tabular Analysis of CIH(Cancer Institute Hospital) Database

I. Summary of Data Fig. 1-14, Table 1-8II. Background Factor

1. Host Factors Table 1-92. Tumor Factors Table 1-443. Diagnosis Table 1-174. Pathology Table 1-135. Treatment Table 1-586. Recurrence Table 1-16

Introduction to the Tabular Analysis of the GastricCancer Database of the Cancer Institute Hospital,Tokyo

Toshifusa Nakajima, Keiichiro Ohta, and Kazushige OhyamaDivision of Gastrointestinal Surgery, Cancer Institute Hospital (CIH)

The Division of Gastrointestinal Surgery of the Cancer Institute Hospital (CIH), Tokyo, has developed a databaseof 12419 gastric cancer patients who were treated at the CIH from 1946 to 1997. The database consists of threeparts: host, tumor, and treatment data. Host data include sex, age, family history, patient history, symptoms, andfollow-up data regarding recurrence, secondary cancer, or cause of death. Tumor data include various aspects oftumor characteristics based on operative findings and histopathological study, and clinical stages according to theGeneral Rules of Gastric Cancer study issued by the Japanese Gastric Cancer Association [1], along with the TNMclassification by VICC/WHo. Treatment data include the type of surgery for primary and recurrent lesions(approach, type of resection, reconstruction method, extent of lymph node dissection, combined resection, postoperative complications), pre- and postoperative chemotherapy (drugs, route of administration, effect), and radiation therapy. All patients were fol1owed up every year for the first five years, and thereafter every five years.

The purposes of the analyses are to provide information on the estimated extent of cancer spread in order toselect the optimum method of treatment in daily practice, and to provide reference data on the state of the art ofgastric cancer treatment for use in various types of clinical trials. The information may be also helpful in obtaining the informed consent of the patient for a proposed treatment.

As shown in Fig. 1-1, the database is divided into subfiles (A to M) according to YES/NO for surgery, resection,multiple lesions in the stomach, or multiple cancers in other organs. Most tables employed combined subfiles E +J, but sometimes other subfiles were used according to the purpose of the analysis. If the subfile that was used isnot shown in the tables, please refer to the total number of cases, which will identify the subfile.

Data analyses were processed by SAS statistical software with an IBM personal computer (300GL).The authors express their sincere thanks to Drs. H. Sugano, T. Kitagawa, Y. Kato, and A. Yanagisawa of the

Department of Pathology, CIH, for their contribution to and support of this database.

Reference

1. Japanese Gastric Cancer Association (1998) Japanese classification of gastric carcinoma, 2nd English edn. Gastric Cancer1:10-24

Summary of Data 197

I. Summary of Data

All cases12419

®I@I

©ISurgery

No237

®I

SurgeryYes

12182I

@Iresection

no933

I

® ®

@Iresection

yes11249 (4)

I

CDISingle ca.

908Multiple ca. Single ca.

25 10575I

CDI ®I

Multiple ca.670

I©I (@!

Singlelesion

9755

Multiplelesions

820

Singlelesion589

Multiplelesions

81

Fig. I-I. Gastric cancers treated at the Cancer Institute Hospital from 1946 to 1997. Numbers in parentheses indicate thenumber of unknown cases

Table I-I. Chronological trend of surgery and lesionsDecade All cases

Single Ca/lesion Multiple(resected) lesions

(resected)

1946-1949 266 197 31950-1959 2129 1599 661960-1969 2401 1900 1421970-1979 2505 1977 2471980-1989 2952 2365 2481990-1997 2166 1717 114

Total 12419 9755 820

Ca, cancer.

Surgery

MultipleCa.

(resected)

429

120137207173

670

Unknown(resected)

31

4

No surgery

Noresection

57 5387 48239 0144 0

63 6643 118

933 237

198 Appendix: Tabular Analysis of CIH Database

Table 1-2. Chronological changes of treatment results in all cases

Decade No. of cases Resection Curative resection Direct mortality Postop. complications(A + B)

1946-1949 266 204 (78.2) 143 (54.8) 27 (l0.3) 110 (42.2)1950-1959 2129 1694 (81.4) 1350 (64.8) 96 (4.6) 547 (26.3)1960-1969 2401 2162 (90.1) 954 (73.8) 101 (4.2) 661 (27.5)1970-1979 2505 2361 (94.3) 2023 (80.8) 42 (1.7) 626 (25.0)1980-1989 2952 2823 (97.8) 2502 (87.7) 24 (0.8) 778 (26.9)1990-1997 2166 2005 (97.9) 1905 (93.1) 16 (0.8) 322 (5.7)

Total 12419 11249 (92.3) 9696 (79.6) 306 (2.5) 3044 (24.9)

Numbers in parentheses are percents.Curability A: No residual tumors with high probability of cure.Curability B: No residual tumors but not evaluable as "Curability A".Japanese Research Society for Gastric Cancer (1995) Japanese classification of gastric carcinoma, 12th edition. Kanehara, Tokyo, p16.

Table 1-3. Chronological changes in various 5-year survival rates

Decade All cases Surgery No resection All resected

1946-1949 22.0 22.0 1.8 27.61950-1959 26.8 27.3 1.3 33.31960-1969 40.4 40.4 0 44.91970-1979 54.8 54.8 0 58.11980-1989 63.5 64.4 4.8 65.81990-1997 76.4 78.2 (52.0) 78.7

Total 51.1 51.5 2.3 55.6

Results are percents.

Singlelesion, resected

27.533.244.257.165.077.7

54.7

Curative,single lesion (AB)

39.441.554.867.974.383.7

64.8

Table 1-4. Stage Grouping (the 11 th edition)

Peritoneal Liver Lymph SerosalDisseminatio Metastasis Node Involvement

I Po Ho N (-) So

II Po Ho NI (+) S,

III Po Ho N2 (+) S2

N3 (+)IV above PI above HI N4 (+) S3

Japanese Research Society for Gastric Cancer (1985) The GeneralRules for the Gastric Cancer Study (in Japanese), 11th edition.Kanehara, Tokyo, p12.

Table 1-5. Stage Grouping (the 12th edition)

PO, HO, MO PO, HI

NO N1 N2 N3 NO,1,2

0 T1 Ia Ib II lila

:::E Iva

0T2 Ib II IlIa lIlb

~ T3 II lila II1b Ivao'~ T4 lila IIIb Iva

P1, HO, Tl,2,3 IvaIvb

(Other Cases)

Japanese Research Society for Gastric Cancer (1995) Japanese Classification of Gastric Carcinoma, 12th edition. Kanehara, Tokyo, p 13.

Table 1-6. Stage Grouping (the 13'h edition)

NO N1 N2 N3

Tl Ia Ib II

T2 Ib II lila

T3 II IlIa Illb

T4 IlIa llIb IV

H1, P1, CY1, M1

Japanese Research Society for Gastric Cancer (1998) Japanese Classification of Gastric Carcinoma, 13th edition. Gastric Cancer 1 :18.

Summary of Data 199

Table 1-7. Summary data for patients who underwent surgery at CIH: single cancer, single

lesion

All cases undergoing surgery All resected cases

Frequency % 5-year Frequency % 5-yearsurvival survival

Gender

Male 6856 64.3 49.5 6251 64.1 54.0

Famale 3807 35.7 51.0 3504 35.9 55.3

Age distribution

:0;19 5 0.0 40.0 5 0.1 40.020-29 126 1.2 38.5 109 1.1 44.530-39 815 7.6 54.8 740 7.6 60.340-49 2138 20.1 55.1 1951 20.0 60.450-59 3249 30.5 51.4 2973 30.5 56.060-69 3081 28.9 46.2 2823 28.9 50.270-79 1128 10.6 44.6 1044 10.7 48.1~80 121 1.1 39.8 110 1.1 40.4

Tumor type

Unknown 20 3071 28.8 94.2 3051 31.3 94.31 152 1.4 58.9 148 1.5 59.92 1883 17.7 42.8 1758 18.0 45.73 3249 30.5 29.4 2868 29.4 33.24 1673 15.7 13.7 1299 13.3 17.45 633 5.9 68.0 631 6.5 68.2

Dissemination

Unknown 4 0.0 58.0 1 0.0PO 9130 85.6 5.7 8724 89.4 60.6PI 336 3.2 0.1 288 3.0 6.7P2 750 7.0 0.1 530 5.4 1.1P3 443 4.2 0 212 2.2 0

Liver metastasis

Unknown 12 0.1 8 0.1 100.0HO 10110 94.8 52.6 9391 96.3 56.5HI 151 1.4 2.8 110 1.1 2.9H2 201 1.9 0.5 139 1.4 0.7H3 189 1.8 0 107 1.1 0

Grade of dissection

No report 860 7 0DO 722 7.4 30.8 668 6.9 31.001 2629 26.8 55.8 2629 27.0 55.802 5807 59.2 58.1 5807 59.6 58.103 582 5.9 37.3 581 6.0 37.304 63 0.6 0 63 0.6 0

Macroscopic T Category (12th edition)

Unknown 2 0.0T1 3028 28.4 94.2 3009 30.8 94.2T2 3036 28.5 58.0 2950 30.2 59.7T3 2737 25.7 24.5 2552 26.2 26.2T4 1860 17.4 5.9 1244 12.8 8.4

Microscopic T Category (12th edition)

Unknown 1053 9.9 167 1.7 81.4T1 2941 27.6 93.9 2925 30.0 93.9T2 2986 28.0 56.2 2983 30.6 56.2T3 3382 31.7 23.9 3381 34.7 24.0T4 301 2.8 7.4 299 3.1 7.5


Table 1-7. (Continued)

All cases undergoing surgery All resected cases

Frequency % 5-year Frequency % 5-yearsurvival survival

Macroscopic stage (11 th edition)

Unknown 15 0.1 11 0.1 100.01 3880 36.4 92.3 3861 39.6 92.32 1315 12.3 65.3 1313 13.5 65.43 2015 18.9 37.2 2012 20.6 37.34 3438 32.2 5.4 2558 26.2 6.5

Microscopic stage (11th edition)

No report 1765 16.6 7.0 872 8.9 13.31 3366 31.6 92.9 3354 34.4 92.82 1246 11.7 71.5 1243 12.7 71.63 2570 24.1 41.3 2570 26.3 41.34 1716 16.1 8.3 1716 17.6 8.3

Macroscopic stage (12th edition)

Unknown 95 0.9 12.5 18 0.2 51.3Ia 2866 26.9 94.9 2849 29.2 94.9Ib 1520 14.3 80.4 1517 15.6 80.4II 1287 12.1 58.8 1286 13.2 58.8IlIa 1187 11.1 35.5 1178 12.1 35.8I1Ib 798 7.5 18.9 772 7.9 19.5IVa 582 5.5 9.7 551 5.6 10.2IVb 2328 21.8 1.8 1584 16.2 2.4

Macroscopic stage (12th edition)

Unknown 1765 16.6 7.0 872 8.9 13.3Ia 2584 24.2 95.6 2573 26.4 95.6Ib 1183 11.1 84.7 1181 12.1 84.7II 1271 11.9 65.4 1269 13.0 65.5IlIa 1286 12.1 43.8 1286 13.2 43.8I1Ib 107] 10.0 23.4 1071 11.0 23.4IVa 515 4.8 ]2.1 515 5.3 ]2.]

IVb 988 9.3 4.6 988 10.1 4.1


No report 234 2.2 29.3 119 1.2 54.4Ia 2866 26.9 94.9 2849 29.2 94.9Ib 1516 14.2 80.4 1513 15.5 80.4II 1247 11.7 58.1 1246 12.8 58.2IlIa 1173 11.0 34.6 1165 11.9 34.9I1Ib 673 6.3 19.4 653 6.7 20.0IV 2954 27.7 3.9 2210 22.7 5.0


No report 1765 16.6 7.0 872 8.9 13.4Ia 2584 24.2 95.6 2573 26.4 95.6Ib 1183 11.1 84.8 1181 12.] 84.8II 1278 12.0 65.5 1276 13.1 65.6IlIa 1300 ]2.2 43.6 1300 13.3 43.7I1Ib 907 8.5 24.0 907 9.3 24.0IV 1646 15.4 7.0 1646 ]6.9 7.6

Summary of Data 201

Table 1-8. Chronological changes in 5-year survival rates for gastric cancer: single gastric cancer with single lesion (n = 10663)Stage No. of cases 1946-1949 1950-1959 1960-1969 1970-1979 1980-1989 1990-1997 1946-1997

Macroscopic classification (11 th edition)

1 3880 73.7 82.0 84.7 93.5 95.4 97.5 92.32 1315 41.5 53.0 61.0 70.8 79.8 84.4 65.33 2015 28.8 23.7 31.5 40.8 47.1 62.0 37.24 3438 3.0 2.2 3.2 7.7 8.6 15.3 5.4

Unknown 15 66.7 100.0 100.0

Microscopic classification (11 th edition)

1 3366 69.2 76.5 89.8 94.5 94.8 97.2 92.92 1246 57.9 54.1 66.4 80.0 81.1 87.3 71.53 2570 24.7 30.5 33.8 45.0 52.5 63.5 41.34 1716 3.9 3.7 5.1 6.3 7.3 21.1 8.3

Unknown 1765 1.4 3.4 3.5 2.8 10.3 82.1 7.0

Macroscopic classification (12th edition)

la 2866 100.0 91.7 92.5 94.3 94.8 97.5 94.9Ib 1520 63.3 69.2 72.5 86.5 90.9 93.9 80.4II 1287 37.8 49.2 52.9 62.6 69.5 82.0 58.8lIla 1187 31.0 21.3 27.0 40.9 46.5 67.0 35.5IIIb 798 8.0 10.1 13.6 20.8 29.4 40.0 18.9IVa 582 10.0 3.5 3.8 10.7 17.6 37.0 9.7IVb 2328 0 0.8 1.2 2.3 2.8 7.5 1.8

Unknown 95 20.0 8.8 0 0 16.7 75.0 12.5

Microscopic classification (12th edition)

Ia 2584 89.8 94.5 95.7 95.2 97.4 95.6Ib 1183 69.2 73.5 79.0 89.7 90.2 93.7 84.7II 1271 56.0 48.9 57.7 70.2 75.3 84.3 65.4lIla 1286 16.7 31.1 38.8 45.7 52.2 66.9 43.8IIIb 1071 21.4 15.3 16.1 23.1 34.8 48.9 23.4IVa 515 6.7 3.1 7.6 11.4 14.3 39.1 12.1IVb 988 0 1.1 1.5 2.0 3.2 11.1 4.6

Unknown 1765 7.4 7.5 8.1 15.7 33.3 93.8 7.0

Macroscopic classification (13th edition)

Ia 2866 100.0 91.7 92.5 94.3 94.8 97.5 94.9Ib 1516 63.3 69.1 72.5 96.4 90.9 93.9 80.4II 1247 37.8 48.1 53.0 61.5 68.6 81.7 58.1lIla 1173 31.8 21.5 25.3 38.8 46.1 65.4 34.6IIIb 673 4.8 8.8 13.9 20.8 29.3 44.6 19.4IV 2954 1.8 1.9 1.8 4.8 6.8 12.5 3.9

Unknown 234 16.7 17.7 26.4 41.8 41.7 88.9 29.3

Microscopic classification (13th edition)

Ia 2584 89.8 94.5 95.7 95.2 97.4 95.6Ib 1183 69.2 73.8 79.4 90.2 90.1 93.7 84.8II 1278 56.0 51.1 59.7 70.3 75.4 84.3 65.5lIla 1300 17.3 32.5 39.8 50.0 53.1 69.7 43.6IIIb 907 28.6 16.3 17.0 23.4 36.1 44.3 24.0IV 1646 1.0 1.8 1.8 4.5 5.5 12.1 7.0

Unknown 1765 1.9 3.9 6.8 6.0 9.1 70.5 14.1


50

56.4%53.2%

51.1%

80

,.

4'

2'

-- ..:.7:::8.1:.::..~ 199~1997 n=2046

-_~--------....--..c..~.~,..~.. 1980-1989 n=2885

--......--- 5~'!A.,~1970-1979 n=2504

------ ...;40~.~4.'\ 1960-1969 n=24()J_-=:::::::::::::::::==,,::.3% 1950-195911=2077

22.0<;t: 1946-1949 n=259

12 24 36 48months arrer surgery

6012 24 "months after surgn"}'

48

Fig. 1-2. Survival curve of all cases treated at CIH: 1946-1997(n = 12419)

Fig. 1-3. Chronological changes of postoperative survivalcurves in all cases that underwent surgery: 1946-1997

- -__....,111" 11=2566 (41..1%1

_-.~_--,I:...;V~ 11=1714 (8..1%)

·~---""" .!II~ 11=1246 (71.5%)

so

%

10°1\:~::::::::::::::------- ---!_!I=.1365 (92.2%)

11=201.\ (.17.2%)

11=1313 (65.3%)

IV 11=.\.04 (5.4%)

-....::::::::::::--------:!!!-. n=I0654(SO.O%)

%

so

lo01~::::::::::::- ~__!.....,11=3879 (92.2%)

12 24 36 48months after surgery

60


60

Fig. 1-4. Survival curves by macroscopic stage (11th edition)Fig. 1-5. Survival curves by microscopic stage (11th edition)

la11=258.1 (95.6%)

Ib11=118.1 (84.7%)

II11=1271 (65.4%)

ilia11=1285 (43.8%)

IIIb11=1069123.4 0/0)

IVan=51J (12.1 %1

IVb11=987 (4.1%)

6024 36 48

months after surgery

%100la

11=2865 (94.9%)

Ib11=1520 (80.4%)

II11=1285 (58.7%)

SO

IlIa11=1186 (.15.5%)

IIIb11=797 (18.9%)

IVa11=581 (9.7%)

IVb 11=2.125 1.8%)


12

Fig. 1-6. Survival curves by macroscopic stage (12th edition) Fig. 1-7. Survival curves by microscopic stage (12th edition)

Summary of Data 203

-.>---=~ n=672 (19.4%)

n=1278 (65.5%)

n=1299 (43.7%)

n=905 (24.0%)

---....--.:..:-.... n=1643 (7.6%)

1~~~~::::::===:::==::==:==~:n=2583(95.6%)n= ll83 (84.8%)

n=ll72 (34.6%)

%100

n=2865 (94.9%)

n=1516 (80.4%)

n=1245 (58.1 %)

50

n=2950 (3.9%)IV

%

50

100 ~~::::::===:::::::=::- .-.!:.'.-...."


60 12 24 36 48months after surgery

60

Fig. 1-8. Survival curves by macroscopic stage (13th edition) Fig. 1-9. Survival curves by microscopic stage (13th edition)

1OOl~:::::---'-----' --,>--__--,_2:!.'~~n=4946 (87.3%)

50

n=4700 (40.7%)

n=1594 0.3%)


60

Fig. 1-10. Postoperative survival curves according to curability in all resected cases: 1946-1997 (13th edition)

0- 69 (30.0%) 70-79 80 -ge

M.le(6S.3%e.<

Tumor0(33.0% 2 3 4 5

type

Middle (35.8%)

Lnd(macro)

n. (42.7%) "' OJ O.Lnd(micro)

0 20 40 60 80 100%

Fig. 1-11. Main prognostic factors of gastric cancer in all resected cases (1)


~IR g

o

- PO (90.3"0) PI P2 P3

1-- HO(96A~) III ........U~ I

ilI/- u"kno~n TI (J1.9~) 1'2 (JOA%) T3 (33.1'A» nI of I- I. (30.7%) Ib(15.9%) U (13.2'A» III. mb IV. IVbgc I

- unknown 1.128.07.) Ib II III. IIlb IV. IVbC I I I- CUnlbility A (4-1.6'7.) CUnlbility 8 (3-1.8%) Curabilitv C

I I I- Oist., g. (59.7'A»

.~egm n' Foc:ll Po I E:Pro•. ~.(4.1%) TOL'lI~.(27.2~i ·'·T nO ....

I r-I --I

un,hill

l)pc ofres tiol

Livermetnst.nsi

Oisseminalion

\ allinvasiOJ

Mirro-S1ng(12th cdn)

Marro·sl.ll(12th cdn)

20 40 60 80 100

Fig. 1-12. Main prognostic factors of gastric cancer (2). g, gastrectomy; Post EMR g, gastrectomy after endoscopic mucosalresection; no res, no resection

-16· -19 60·69

DII,,~)mlllUm

_ eli;, '(lllll'"rl

Dpain

~d.sphagia

_ mi. ccllancous

70·79 80·89 90·97

Fig. I-B. Chronological changes in symptoms

no. cases2500 n=2353

44.0%

2000

1500

1000

500

n=197331.3%

n=156854.7%

46-49 50-59 60-69 70-79 80-89 90-97

Fig. 1-14. Increase in early-stage cancer

Background Factor· Host Factors 205

II. Background Factor

1. Host FactorsTable 11-1.1. Clinical background of Table 11-1.4. Synchronous cancer in

all cases treated at CIH all cases treated at CIH

Gender Frequency % Cancer site Frequency %

Male 8110 65.3 Unknown 8 0.1Female 4309 34.7 None 12204 98.3

12419 Head 2 0.0Neck 7 0.1Esophagus 31 0.2Stomach 12 0.1

Table 11-1.2. Age distributionSmall intestine 1 0.0Colon 42 0.3

of all cases treated at CIH Rectum 18 0.1Age Frequency % Liver 9 0.1

~19 6 0.0Gallbladder 4 0.0Pancreas 6 0.0

20-29 130 1.0Breast 9 0.1

30-39 862 6.9Lung 5 0.0

40-49 2312 18.650-59 3719 29.9

Urinary 11 0.1

60-69 3729 30.0Genital 2 0.0Endocrine 2 0.0

70-79 1496 12.0Extremity 12 0.1

~80 165 1.3Miscellaneous 34 0.3

1241912419

Table 11-1.3. Cancer history of all Table 11-1.5. Metachronous cancer in all cases

cases treated at CIH treated at CIH

History of cancer Frequency % Metachronous cancer Frequency %

Unknown 7 Unknown 799 6.4None 12086 97.4 None 11399 91.8Head 11 0.1 Head 9 0.1Neck 36 0.3 Neck 5 0.0Esophagus 5 0.0 Esophagus 22 0.2Stomach 5 0.0 Stomach 24 0.2Colon 46 0.4 Colon 17 0.1Rectum 26 0.2 Rectum 21 0.2Gallbladder 1 0.0 Liver 15 0.1Pancreas 1 0.0 Gallbladder 12 0.1Breast 73 0.6 Pancreas 9 0.1Lung 13 0.1 Breast 4 0.0Urinary 12 0.1 Lung 40 0.3Genital 80 0.6 Urinary 10 0.1Endocrine 6 0.0 Genital 14 0.1Extremity 2 0.0 Endocrine 3 0.0Miscellaneous 9 0.1 Miscellaneous 16 0.1

12419 12419


Table 11-1.6. Symptoms at admissionin all cases treated at CIH

Table 11-1.7. Preoperative diagnosis In allcases treated at CIH

Symptom' Frequency %

Unknow 43 0.3None 2609 21.0Extragastric 554 4.5Indefinite 6176 49.7Ulcer-like 2326 18.7Dysphagia 640 5.2Miscellaneous 71 0.6

12419

"Extragastric, bleeding (e.g.,occult blood);Indefinite, discomfort, fullness; Ulcer-like,pain; Dysphagia, swallowing difficulty.

Frequency

1912137

1862723

11016

12419

0.297.7

1.50.20.20.00.10.1

Table 11-1.8. Chronological changes in the clinical backgrounds in all cases treated at CIH

Parameter 1946-1949 1950-1959 1960-1969 1970-1979 1980-1989 1990-

Gender

Male 178 1377 1498 1614 1979 1464(66.92) (64.68) (62.39) (64.43) (67.04) (67.59)

Female 88 752 903 891 973 702(33.08) (35.32) (37.61) (35.57) (32.96) (32.41)

Total 266 2129 2401 2505 2952 2166(2.14) (17.14) (19.33) (20.17) (23.77) (17.44)

Age distribution

~19 1 2 0 0 1 2(0.38) (0.09) (0.00) (0.00) (0.03) (0.09)

20-29 5 30 41 23 18 13(1.88) (1.41) (1.71 ) (0.92) (0.61) (0.60)

30-39 41 161 196 200 197 67(15.41) (7.56) (8.16) (7.98) (6.67) (3.09)

40-49 85 450 427 480 518 352

(31.95) (21.14) (17.78) (19.16) (17.55) (16.25)

50-59 90 810 698 666 822 633(33.83) (38.05) (29.07) (26.59) (27.85) (29.22)

60-69 42 574 807 790 836 680(15.79) (26.96) (33.61 ) (31.54) (28.32) (31.39)

70-79 1 98 226 318 493 360

(0.38) (4.60) (9.41) (12.69) (16.70) (16.62)

~80 1 4 6 28 67 59(0.38) (0.19) (0.25) (1.12) (2.27) (2.72)

Total 266 2129 2401 2505 2952 2166

(2.14) (17.14) (19.40) (20.17) (23.77) (17.44)

Results are frequencies and percents.(%)

Total

8110(65.30)

4309(34.70)

12419

6(0.048)

130(1.05)

862(6.94)

2312(18.62)

3719(29.95)

3729(30.03)

1496(12.05)

165(1.33)

12419

Background Factor' Host Factors 207

Table 11-1.9. Correlation of host factors for all patients undergoing surgery

Gender and age distribution: frequency and percent

::;19 20-29 30-39 40-49 50-59 60-69 70-79 280 Total

Male 2 60 412 1338 2439 2579 1010 106 7946(0.03) (0.76) (5.18) (16.84) (30.69) (32.46) (12.71) (1.33) (65.23)

Female 3 69 436 945 1226 1081 432 44 4236(0.07) (1.63) (10.29) (22.31) (28.94) (25.52) (10.20) (1.04) (34.77)

Total 5 129 848 2283 3665 3660 1442 150 12182(0.041) (1.06) (6.96) (18.74) (30.08) (30.04) (11.84) (1.23)

Gender and clinical stages (13th edition): frequency and percent

Ia Ib II IlIa I1Ib IV Total

Male 152 2337 1171 917 855 491 2023 7946(1.91) (29.41) (14.74) (11.54) (10.76) (6.18) (25.46) (65.23)

Female 97 1141 611 524 459 256 1148 4236(2.29) (26.94) (14.42) (12.37) (10.84) (6.04) (27.10) (34.77)

Total 249 3478 1782 1441 1314 747 3171 12182(2.04) (28.55) (14.62) (11.83) (10.79) (6.13) (26.03)

Age and symptoms at admission: frequency and percent

Age Unknown None Extragastric Discomfort Ulcer-like Dysphagia Misc. Total

::;19 0 0 1 3 1 0 0 5(0) (0) (20.00) (60.00) (20.00) (0) (0) (0.41)

20-29 0 3 3 64 49 10 0 129(0) (2.33) (2.33) (49.61 ) (37.98) (7.75) (0) ( 1.06)

30-39 1 68 26 419 303 29 2 848(0.12) (8.02) (3.07) (49.41) (35.73) (3.42) (0.24) ( 6.96)

40-49 5 423 75 1118 560 91 11 2283(0.22) (18.53) (3.29) (48.97) (24.53) (3.99) (0.48) (18.74)

50-59 15 784 171 1827 674 181 13 3665(0.41) (21.39) (4.67) (49.85) (18.39) (4.94) (0.35) (30.09)

60-69 7 825 178 1889 522 215 24 3660(0.19) (22.54) (4.86) (51.61) (14.26) (5.87) (0.66) (30.04)

70-79 7 412 81 672 171 92 7 1442(0.49) (28.57) (5.62) (46.60) (11.86) (6.38) (0.49) (11.84)

280 1 40 9 74 15 6 5 150(0.67) (26.67) (6.00) (49.33) (10.00) (4.00) (3.33) ( 1.23)

Total 36 2555 544 6066 2295 624 62 12182(0.29) (20.97) (4.47) (49.79) (18.83) (5.12) (0.50)

Tumor types and symptoms: frequency and percent

Unknown None Extragastric Indefinite Ulcer-like Dysphagia Misc Total

Early 8 1786 98 1164 671 11 7 3745(0.21) (47.70) (2.62) (31.06) (17.92) (0.29) (0.19) (30.74)

Borrl 1 50 19 87 22 9 2 190(0.53) (26.32) (10.00) (45.79) (11.58) (4.74) (1.05) (1.56)

Borr2 6 145 169 1296 359 181 4 2160(0.28) (6.71) (7.82) (60.00) (16.62) (8.38) (0.19) (17.73)

Borr3 9 314 152 2022 764 270 33 3564(0.25) (8.81) (4.26) (56.73) (21.44) (7.58) (0.93) (29.26)

Borr4 10 81 75 1181 276 125 12 1760(0.57) (4.60) (4.26) (67.10) (15.68) (7.10) (0.68) (1.44)

Mixed 2 179 31 316 203 28 4 763(0.26) (23.49) (4.07) (41.47) (26.64) (3.54) (0.52) (6.26)

Total 36 2555 544 6065 2295 623 62 12182

(0.29) (20.97) (4.46) (49.78) (18.83) (5.114) (0.50)


Table 11-1.9. (Continued)Age and preoperative complications: frequency and percent

None Anemia Hypertension Pulmonary Cardiac Mise Total

:0;19 3 1 0 0 0 1 5(50.00) (0) (0) (0) (50.00) (0.04)

20--29 103 19 0 0 0 7 129(73.08) (0) (0) (0) (26.92) (1.06)

30-39 719 88 0 1 3 37 848(68.22) (0) (0.78) (2.33) (28.68) (6.96)

40--49 1876 277 12 3 20 95 2283(68.06) (2.95) (0.74) (4.91) (23.34) (18.74)

50--59 2892 450 41 20 36 226 3665(58.21) (5.30) (2.59) (4.66) (29.24) (30.09)

60--69 2764 377 94 37 94 294 3660(42.08) (10.49) (4.13) (10.49) (32.81) (30.04)

70--79 1056 95 68 35 62 126 1442(24.61) (17.62) (9.07) (16.06) (32.64) (11.84)

:2:80 118 3 9 3 8 9 150(9.38) (28.13) (9.38) (25.00) (28.13) (1.23)

Total 9531 1310 224 99 223 795 12182(78.23) (10.75) (1.83) (0.81) (1.83) (6.53)

Age and macroscopic stage classification (13lh edition): frequency and percent

Unknown Ia Ib II IlIa IlIb IV Total

:0;9 0 0 0 2 0 0 3 5(0) (0) (0) (40.00) (0) (0) (60.00) (0.04)

20--29 3 27 10 20 11 3 55 129(2.33) (20.93) (7.75) (15.50) (8.53) (2.33) (42.64) (1.06)

30-39 20 219 153 106 65 44 241 848(2.36) (25.83) (18.04) (12.50) (7.67) (5.19) (28.42) (6.96)

40-49 46 728 316 266 212 134 581 2283(2.01) (31.89) (13.84) (11.65) (9.29) (5.87) (25.45) (18.74)

50--59 66 1030 559 452 400 239 919 3665(1.80) (28.10) (15.25) (12.33) (10.91) (6.52) (25.08) (30.09)

60--69 75 976 547 427 435 217 983 3660(2.05) (26.67) (14.95) (11.67) (11.89) (5.93) (26.86) (30.04)

70--79 34 462 175 145 172 97 357 1442(2.36) (32.04) (12.14) (10.06) (11.93) (6.73) (24.76) (11.84)

:2:80 5 36 22 23 19 13 32 150(3.33) (24.00) (14.67) (15.33) (12.67) (8.67) (21.33) (1.23)

Total 249 3478 1782 1441 1314 747 3171 12182(2.04) (28.55) (14.62) (11.82) (10.78) (6.13) (26.03)

Age and tumor locations: frequency and percent

Unknown Cardiac Upper Middle Lower Total

:0;19 0 0 0 2 3 5(0.00) (0.00) (40.00) (60.00) (0.04)

20-29 0 15 9 55 50 129(11.63) (6.98) (42.64) (38.76) (1.06)

30-39 0 61 93 418 276 848(7.19) (10.97) (49.29) (32.55) (6.96)

40--49 0 139 206 1099 839 2283(6.09) (9.02) (48.14) (36.75) (18.74)

50--59 0 245 383 1529 1508 3665(6.68) (10.45) (41.72) (41.15) (30.09)

Background Factor· Host Factors 209

Table 11-1.9. (Continued)Age and tumor locations: frequency and percent

Unknown Cardiac Upper Middle Lower Total

60-69 1 275 469 1426 1489 3660(7.52) (12.82) (38.97) (40.69) (30.04)

70-79 104 211 565 561 1442(7.22) (14.64) (39.21) (38.93) (11.84)

~80 0 12 20 49 69 150(8.00) (13.33) (32.67) (46.00) (1.23)

Total 2 851 1391 5143 4795 12182(0.016) (6.98) (11.41) (42.21) (39.36)

Tumor cell types and locations by age: frequency and percent

Cardiac Upper Middle Lower Whole Total

Age $19Differ. 0 1 0 1

(0) (100.00) (0) (20.00)

Undif. 1 1 2 4(25.00) (25.00) (50.00) (80.00)

Total 1 2 2 5(20.00) (40.00) (40.00)

................................. ............................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . .. . .. . . . . . . . ... . .

Age 20-29Differ. 3 1 2 4 0 10

(30.00) (10.00) (20.00) (40.00) (0) (9.17)

Undiff. 11 3 30 36 17 97(11.34) (3.09) (30.93) (37.11) (17.53) (88.99)

Misc. 1 0 1 0 0 2(50.00) (0) (50.00) (0) (0) (1.83)

Total 15 4 33 40 17 109(13.76) (3.66) (30.27) (36.69) (15.60)

. ... ... . . . . . . . . . . . . . . . . .. . .. . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .... . . ....................Age 30-39

Unknown 0 0 2 1 4(0.54)

Differ. 13 8 39 47 9 116(11.21) (6.90) (33.62) (40.52) (7.76) (15.76)

Undiff. 44 66 243 160 107 620(7.10) (10.65) (39.19) (25.81) (17.26) (84.24)

Total 57 74 284 208 117 736(7.74) (10.05) (38.59) (38.26) (15.90)

....... - ...........Age 40-49"

Unknown 3 13 14 32(1.64)

Differ. 37 45 197 277 25 581(6.37) (7.75) (33.91) (47.68) (4.30) (29.78)

Undiff. 80 110 558 359 224 1331(6.01) (8.26) (41.92) (26.97) (16.83) (68.22)

Misc. 3 0 3 1 0 7(42.86) (0) (42.86) (14.29) (0) (0.36)

Total 123 156 771 651 250 1951(6.30) (7.80) (39.51) (33.36) (12.81)

"Frequency missing =32.


Table 11-1.9. (Continued)

Tumor cell types and locations by age: frequency and percent

Cardiac Upper Middle Lower Whole Total

Age 50-59Unknown 3 6 16 18 3 46

(1.55)

Differ. 107 130 419 653 72 1381(7.75) (9.41) (30.34) (47.28) (5.21 ) (46.45)

Undiff. 97 143 600 459 226 1525(6.36) (9.38) (39.34) (30.10) (14.82) (51.29)

Misc. 10 3 1 4 3 21(47.62) (14.29) (4.76) (19.05) (14.29) (0.71)

Total 217 282 1036 1134 304 2973(7.29) (9.48) (34.84) (38.14) (10.23)

. . . ..... ... . . . . . . . . . . .. ........ . .......... , .......... , ........Age 60-69

Unknown 6 13 35 18 73(2.59)

Differ. 111 166 493 678 91 1539(7.21) (10.79) (32.03) (44.05) (5.91) (54.52)

Undiff. 86 134 400 376 189 1185(7.26) (11.31 ) (33.76) (31.73) (15.95) (41.98)

Misc. 11 3 2 8 2 26(42.31) (11.54) (7.69) (30.77) (7.69) (0.92)

Total 214 316 930 1080 283 2823(7.58) (11.19) (32.94) (38.26) (10.02)

................. -., ........ - .. -., ..... •• •• _ •• _., .......... _......... ,. '0-" .... _••••

Age 70-79Unknown 4 10 11 0 26

(2.49)

Differ. 52 84 212 239 38 625(8.32) (13.44) (33.92) (38.24) (6.08) (59.87)

Undiff. 32 43 112 122 77 386(8.29) (11.14) (29.02) (31.61) (19.95) (36.97)

Misc. 1 1 1 3 1 7(14.29) (14.29) (14.29) (42.86) (14.29) (0.67)

Total 86 132 335 375 116 1044(8.23) (12.64) (32.08) (35.92) (11.11)

., ..... - ........... - ...................................................Age :2:80

Unknown 1 2 1 2 0 6

Differ. 8 8 24 29 3 72(11.11) (11.11) (33.33) (40.28) (4.17)

Undiff. 3 3 5 17 3 31(9.68) (9.68) (16.13) (54.84) (9.68)

Misc. 1 0 0 0 0(100.00) (0.00) (0.00) (0.00) (0.00)

Total 13 13 30 48 6 110(11.81) (11.81) (27.27) (43.63) (5.45)

725 977 3420 3538 1095 9755(7.43) (10.01) (3.506) (36.27) (11.26)

(%)

Background Factor· Tumor Factors 211

Present Frequency %

Table 11-2.6. Incidence of earlysingle cancer lesion

Table 11-2.7. Tcategory (11 th edition)(single cancer lesion)

2. Tumor FactorsTable 11-2.1. Location of singlecancer lesion

Site Frequency %

Cardia 725 7.4Upper 977 10.0Middle 3420 35.1Lower 3538 36.3Whole 1095 11.2

9755

YesNo

30516704

9755

31.368.7

Category Frequency %

Table 11-2.2. Size of single cancerlesion

Size Frequency %

Large 2890 29.6Medium 4125 42.3Small 2740 28.1

9755

UnknownMSMMPSSSESI-SEI

16716191306916

20673381299

9755

1.716.613.49.4

21.234.7

3.1

Table 11-2.3. Circumference of singlecancer lesion

Circumference

No descriptionLesser curvatureGreater curvatureAnteriorPosteriorCircular

Frequency %

50541683 35.8523 ILl900 19.1946 20.1649 13.8

9755

Table 11-2.8. Tcategory (12th edition)(single cancer lesion)


Unknown 167 1.7Tl 2925 30.0T2 2983 30.6T3 3381 34.7T4 299 3.1

9755


Table 11-2.11. Lavage cytology Table 11-2.15. Microscopic lymph(single cancer) node metastasis (12th edition) (single

Class Frequency % cancer)

Unknown 97 1.0 Metastasis Frequency %

Not done 8909 91.3 Unknown 783 8.01 364 3.7 NO 3995 41.02 124 1.3 N1 1936 19.83 29 0.3 N2 2050 21.04 45 0.5 N3 556 5.75 187 1.9 N4 435 4.5

9755 9755

Table 11-2.12. Liver metastasis Table 11-2.16. Macroscopic lymph(single cancer) node metastasis (13 th edition) (singleMetastasis Frequency % cancer)

Unknown 8 0.1 Metastasis Frequency %

HO 9391 96.3 Unknown 172 1.8HI 110 1.1 NO 4965 50.9H2 139 1.4 N1 1987 20.4H3 107 1.1 N2 1638 16.8

9755 N3 893 9.2N4 100 1.0

9755

Table 11-2.14. Macroscopic lymphnode metastasis (12th edition) (singlecancer)

Frequency %

Unknown 42 0.4NO 4965 50.9N1 2078 21.3N2 1622 16.6N3 470 4.8N4 578 5.9

9755

Metastasis Frequency

Table 11-2.13. Location ofmetastasis (single cancer)

Unknown 783 8.0NO 3995 41.0N1 1962 20.1N2 2066 21.2N3 822 8.4N4 127 1.3

9755

Table 11-2.18. TNM n-category(single cancer)


Unknown 313 3.2NO 3998 41.0N1 3346 34.3N2 1625 16.7N3 473 4.8

9755

Metastasis Frequency %

Table 11-2.17. Microscopic lymphnode metastasis (13th edition) (singlecancer)

%

23.115.561.4

liver

93878557

226

9755

NoneRightLeftBoth


Table 0-2.19. Macroscopic stages Table 11-2.23. Macroscopic stages(11 th edition) (single cancer) (13th edition) (single cancer)

Stage Frequency % Stage Frequency %

Unknown 11 0.1 Unknown 119 1.21 3861 39.6 Ia 2849 29.22 1313 13.5 Ib 1513 15.53 2012 20.6 II 1246 12.84 2558 26.2 IlIa 1165 11.9

9755 I1Ib 653 6.7IV 2210 22.7

9755

Table 11-2.20. Microscopic stages(11 th edition) (single cancer)

Stage Frequency % Table 11-2.24. Microscopic stages(13th edition) (single cancer)

No report 872 8.9 Stage Frequency %1 3354 34.42 1243 12.7 Unknown 872 8.93 2570 26.3 Ia 2573 26.44 1716 17.6 Ib 1181 12.1

9755 II 1276 13.1lIla 1300 13.3I1Ib 907 9.3IV 1646 16.9

Table 11-2.21. Macroscopic stage 9755(12th edition) (single cancer)

Stage Frequency %

Unknown 18 0.2 Table 0-2.25. TNM stage (singleIa 2849 29.2 cancer)Ib 1517 15.6 Stage Frequency %II 1286 13.2lIla 1178 12.1 Unknown 443 4.5IIIb 772 7.9 0 1547 15.9IVa 551 5.6 IA 1015 10.4IVb 1584 16.2 IE 1211 12.4

9755 II 1644 16.9lIlA 1403 14.4IIIB 810 8.3IV 1682 17.2

Table 11-2.22. Microscopic stage 9755(12th edition) (single cancer)

Stage Frequency %

Unknown 872 8.9Ia 2573 26.4Ib 1181 12.1II 1269 13.0lIla 1286 13.2IIIb 1071 11.0IVa 515 5.3IVb 988 10.1

9755


Table 11-2.26. Chronological changes in the clinical backgrounds: resected single gastric cancer with single lesion (frequencyand percent)

1946-1949 1950-1959 1960-1969 1970-1979 1980-1989 1990- Total

Tumor type

Early I 63 344 645 1056 942 3051(0.51 ) (3.94) (18.11) (32.63) (44.61 ) (54.93) (31.28)

Type 1 2 25 33 32 39 17 148(1.02) (1.56) (1.74) (1.62) (1.65) (0.99) (1.52)

Type 2 58 498 495 328 259 120 1758(29.44) (31.14) (26.05) (16.59) (10.94) (7.00) (18.02)

Type 3 101 661 627 586 539 354 2868(51.27) (41.34) (33.00) (29.64) (22.77) (20.64) (29.40)

Type 4 35 290 238 287 291 158 1299(17.77) (18.14) (12.53) (14.52) (12.29) (9.21) (13.32)

Mixed 0 62 163 99 183 124 631(0) (3.88) (8.58) (5.01) (7.73) (7.23) (6.47)

Total 197 1599 1900 1977 2367 1715 9755(2.01 ) (16.39) (19.47) (20.26) (24.26) (17.58)

Early cancer

Early 1 63 344 645 1056 942 3051(0.51 ) (3.94) (18.11) (32.63) (44.61) (54.93) (31.28)

Advanced 196 1536 1556 1332 1311 773 6704(99.49) (96.06) (81.89) (67.37) (55.39) (45.07) (68.72)

Total 197 1599 1900 1977 2367 1715 9755(2.01) (16.39) (19.47) (20.26) (24.26) (17.58)

Tumor location

Cardia 7 112 170 155 168 113 725(3.55) (7.00) (8.95) (7.84) (7.10) (6.59) (7.43)

Upper 3 40 129 205 335 265 977(1.52) (2.50) (6.79) (10.37) (14.15) (15.45) (10.02)

Middle 39 327 558 738 1028 730 3420(19.80) (20.45) (29.37) (37.33) (43.43) (42.57) (35.06)

Lower 134 987 741 607 579 490 3538(68.02) (61.73) (39.00) (30.70) (24.46) (28.57) (36.27)

Whole 14 133 302 272 257 117 1095(7.11 ) (8.32) (15.89) (13.76) (10.86) (6.82) (11.23)

Total 197 1599 1900 1977 2367 1715 9755(2.01) (16.39) (19.47) (20.26) (24.26) (17.58)

Size

Small 1 88 264 522 973 892 2740(0.51) (5.50) (13.89) (26.40) (41.11) (52.01) (28.09)

Medium 103 820 951 879 840 532 4125

(52.28) (51.28) (50.05) (44.46) (35.49) (31.02) (42.29)

Large 93 691 685 576 554 291 2890

(47.21) (43.21 ) (36.05) (29.14) (23.41 ) (16.97) (29.63)

Total 197 1599 1900 1977 2367 1715 9755

(2.02) (16.39) (19.47) (20.26) (24.26) (17.58)


Table 11-2.26. (Continued)1946-1949 1950-1959 1960-1969 1970-1979 1980-1989 1990- Total

Circumference

No description 0 0 1891 1957 1182 24 5054'(51.81)

Lesser cardia 101 695 2 11 364 510 1683(51.27) (43.46) (22.22) (55.00) (30.72) (30.16) (17.25)

Greater cardia 24 199 0 0 110 190 523(12.18) (12.45) (0) (0) (9.28) (11.24) (5.36)

Anterior 31 219 3 1 275 371 900(15.74) (13.70) (33.33) (5.00) (23.21) (21.94) (9.23)

Posterior 25 235 2 6 252 426 946(12.69) (14.70) (22.22) (30.00) (21.27) (25.19) (9.70)

Circular 16 251 2 2 184 194 649(8.12) (15.70) (22.22) (10.00) (15.53) (11.47) (6.65)

Total 197 1599 1900 1977 2367 1715 9755(2.02) (16.39) (19.47) (20.26) (24.26) (17.58)

'These data were not listed in the primary coding items.

Macroscopic lymph node metastasis by the 12th Edition

Unknown 1 9 15 10 5 2 42(0.51) (0.56) (0.79) (0.51) (0.21) (0.12) (0.43)

NO 47 500 858 1052 1398 1110 4965(23.86) (31.27) (45.16) (53.21) (59.06) (64.72) (50.90)

N1 59 498 394 411 440 276 2078(29.95) (31.14) (20.74) (20.79) (18.59) (16.09) (21.30)

N2 62 386 391 321 285 177 1622(31.47) (24.14) (20.58) (16.24) (12.04) (10.32) (16.63)

N3 24 122 104 77 84 59 470(12.18) (7.63) (5.47) (3.89) (3.55) (3.44) (4.82)

N4 4 84 138 106 155 91 578(2.03) (5.25) (7.26) (5.36) (6.55) (5.31) (5.93)

Total 197 1599 1900 1977 2367 1715 9755(2.02) (16.39) (19.48) (20.27) (24.26) (17.58)

Microscopic lymph node metastasis by the 12th Edition

Unknown 54 283 156 103 65 122 783(27.41) (17.70) (8.21) (5.21) (2.75) (7.11) (8.03)

NO 32 304 563 885 1237 974 3995(16.24) (19.01) (29.63) (44.76) (52.26) (56.79) (40.95)

N1 47 390 443 402 416 238 1936(23.86) (24.39) (23.32) (20.33) (17.57) (13.88) (19.85)

N2 54 453 520 429 389 205 2050(27.41) (28.33) (27.37) (21.70) (16.43) (11.95) (21.01)

N3 10 130 145 93 100 78 556(5.08) (8.13) (7.63) (4.70) (4.22) (4.55) (5.70)

N4 0 39 73 65 160 98 435(0) (2.44) (3.84) (3.29) (6.76) (5.71) (4.45)

Total 197 1599 1900 1977 2367 1715 9755(2.02) (16.39) (19.48) (20.27) (24.26) (17.58)



Macroscopic lymph node metastasis by the 13lh edition

Unknown 1 53 52 32 26 8 172(0.51) (3.31) (2.74) (1.62) (1.10) (0.47) (1.76)

NO 47 500 858 1052 1398 1110 4965(23.86) (31.27) (45.16) (53.21) (59.06) (64.72) (50.90)

N1 59 470 367 394 425 272 1987(29.95) (29.39) (19.32) (19.93) (17.96) (15.86) (20.37)

N2 73 390 398 323 277 177 1638(37.06) (24.39) (20.95) (16.34) (11.70) (10.32) (16.79)

N3 17 177 213 165 201 120 893(8.63) (11.07) (11.21) (8.35) (8.49) (7.00) (9.15)

N4 0 9 12 11 40 28 100(0) (0.56) (0.63) (0.56) (1.69) (1.63) (1.03)

Total 197 1599 1900 1977 2367 1715 9755(2.02) (16.39) (19.48) (20.26) (24.26) (17.58)

Microscopic lymph node metastasis by the 13lh edition

Unknown 54 283 156 103 65 122 783(27.41) (17.70) (8.21) (5.21) (2.75) (7.11) (8.03)

NO 32 304 563 885 1237 974 3995(16.24) (19.01 ) (29.63) (44.76) (52.26) (56.79) (40.95)

N1 47 399 449 411 416 240 1962(23.86) (24.95) (23.63) (20.79) (17.57) (13.99) (20.11)

N2 59 459 529 422 388 209 2066(29.95) (28.71) (27.84) (21.35) (16.39) (12.19) (21.18)

N3 5 148 192 142 207 128 822(2.54) (9.26) (10.11) (7.18) (8.75) (7.46) (8.43)

N4 0 6 11 14 54 42 127(0) (0.38) (0.58) (0.71) (2.28) (2.45) (1.30)

Total 197 1599 1900 1977 2367 1715 9755(2.02) (16.39) (19.48) (20.26) (24.26) (17.58)

Macroscopic wall invasion by the 121h edition

Unknown 29 447 372 244 112 0 1204(14.72) (27.95) (19.58) (12.34) (4.73) (0) (12.34)

T1 1 67 342 633 1034 932 3009(0.51) (4.19) (18.00) (32.02) (43.68) (54.34) (30.84)

T2 0 16 64 62 228 273 643(0) (1.00) (3.37) (3.14) (9.63) (15.92) (6.59)

T3 120 887 798 765 702 383 3655(60.91) (55.47) (42.00) (38.69) (29.66) (22.33) (37.47)

T4 47 182 324 273 291 127 1244(23.86) (11.38) (17.05) (13.81) (12.29) (7.41) (12.75)

Total 197 1599 1900 1977 2367 1715 9755(2.02) (16.39) (19.48) (20.26) (24.26) (17.58)



Microscopic wall invasion by the 12th edition

Unknown 0 1 1 4 14 147 167(0) (0.06) (0.05) (0.20) (0.59) (8.57) (1.71 )

T1 0 80 333 618 1036 858 2925(0) (5.00) (17.53) (31.26) (43.77) (50.03) (29.98)

T2 80 880 761 414 508 340 2983(40.61) (55.03) (40.05) (20.94) (21.46) (19.83) (30.58)

T3 116 573 747 905 721 319 3381(58.88) (35.83) (39.32) (45.78) (30.46) (18.60) (34.66)

T4 1 65 58 36 88 51 299(0.51) (4.07) (3.05) (1.82) (3.72) (2.97) (3.06)

Total 197 1599 1900 1977 2367 1715 9755(2.02) (16.39) (19.48) (20.26) (24.26) (17.58)

Liver metastasis

Unknown 0 0 0 0 0 8 8(0) (0) (0) (0) (0) (0.47) (0.08)

HO 187 1520 1811 1896 2304 1673 9391(94.92) (95.06) (95.32) (95.90) (97.34) (97.55) (96.27)

HI 4 29 32 23 16 6 110(2.03) (1.81 ) (1.68) (1.16) (0.68) (0.35) (1.13)

H2 4 31 30 39 23 12 139(2.03) (1.94) (1.58) (1.97) (0.97) (0.70) (1.42)

H3 2 19 27 19 24 16 107(1.02) (1.19) (1.42) (0.96) (1.01) (0.93) (1.09)

Total 197 1599 1900 1977 2367 1715 9755(2.02) (16.39) (19.48) (20.26) (24.26) (17.58)

Location of liver metastasis

Unknownb 187 1518 1810 1901 2289 1682 9387

Right 3 21 24 6 28 3 85(30.00) (25.93) (26.67) (7.89) (35.90) (9.09)

Left 1 12 16 18 5 5 57(10.00) (14.81) (17.78) (23.68) (6.41) (15.15)

Both 6 48 50 52 45 25 226(60.00) (59.26) (55.56) (68.42) (57.69) (75.76)

Total 10 81 90 76 78 33 368(2.71) (22.01) (24.46) (20.65) (21.20) (8.97)

bFrequency missing = 9387.

Peritoneal dissemination

Unknown 0 0 0 0 0 1 1(0) (0) (0) (0) (0) (0.06) (0.01)

PO 160 1393 1668 1765 2159 1579 8724(81.22) (87.12) (87.79) (89.28) (91.21) (92.07) (99.68)

PI 8 65 54 73 59 29 288(4.06) (4.07) (2.84) (3.69) (2.49) (1.69) (2.95)

P2 23 89 134 120 107 57 530(11.68) (5.57) (7.05) (6.07) (4.52) (3.32) (5.43)

P3 6 52 44 19 42 49 212(3.05) (3.25) (2.32) (0.96) (1.77) (2.86) (2.17)

Total 197 1599 1900 1977 2367 1715 9755(2.02) (16.39) (19.48) (20.27) (24.26) (17.58)

218 Appendix: Tabular Analysis of eIR Database


1946-1949 1950-1959 1960-1969 1970-1979 ]980-1989 1990- Total

Location of dissemination

Unknown' 160 1392 1677 1802 2176 1586 8793

Perigastric 3 28 19 23 33 12 118(8.11) (13.53) (8.52) (13.14) (17.28) (9.30) (12.27)

Diaphragm 0 4 2 5 7 8 26(0) (1.93) (0.90) (2.86) (3.66) (6.20) (2.70)

Bursa 2 20 16 20 9 11 78(5.41) (9.66) (7.17) (11.43) (4.71 ) (8.53) (8.11)

Mesocolon 4 26 20 17 29 12 108(10.81) (12.56) (8.97) (9.71) (15.18) (9.30) (11.23)

Mesenterium 0 8 14 13 16 9 60(0) (3.86) (6.28) (7.43) (8.38) (6.98) (6.24)

Ovarium 0 4 7 3 6 2 22(0) (1.93) (3.14) (1.71) (3.14) (1.55) (2.29)

Douglas 24 79 114 74 46 30 367(64.86) (38.16) (51.12) (42.29) (24.08) (23.26) (38.15)

Whole peritoneum 4 38 31 20 45 44 182(10.81) (18.36) (13.90) (11.43) (23.56) (34.11) (18.92)

Navel 0 0 0 0 0 1 1(0) (0) (0) (0) (0) (0.78) (0.10)

Total 37 207 223 175 191 129 962(3.85) (21.51) (23.18) (]8.19) (19.85) (13.41)

'Frequency missing =8793.

Lavage cytology

Unknown 0 0 6 55 24 12 97(0) (0) (0.32) (2.78) (1.01 ) (0.70) (0.99)

Not done 195 1597 1894 1602 2292 1329 8909(98.98) (99.87) (99.68) (81.03) (96.83) (77.49) (91.32)

Class 1 1 1 0 109 21 232 364(0.51) (0.06) (0) (5.51) (0.89) (13.53) (3.73)

Class 2 0 0 0 108 8 8 124(0) (0) (0) (5.46) (0.34) (0.47) (1.27)

Class 3 0 0 0 22 0 7 29(0) (0) (0) (1.11) (0) (0.41) (0.30)

Class 4 0 0 0 41 0 4 45(0) (0) (0) (2.07) (0) (0.23) (0.46)

Class 5 1 1 0 40 22 123 187(0.5] ) (0.06) (0) (2.02) (0.93) (7.17) (1.92)

Total 197 1599 1900 1977 2367 1715 9755(2.02) (16.39) (19.48) (20.27) (24.26) (17.58)

(%)


Table 11-2.27. Tumor size and macroscopic lymph node metastasis (12th edition) (singlecancer)Tumor size Unknown NO N1 N2 N3 N4 Total

Small 2 2415 219 68 13 23 2740(0.07) (88.14) (7.99) (2.48) (0.47) (0.84) (28.09)

Medium 10 1861 997 772 260 225 4125(0.24) (45.12) (24.17) (18.72) (6.30) (5.45) (42.29)

Large 30 689 862 782 197 330 2890(1.04) (23.84) (29.83) (27.06) (6.82) (11.42) (29.63)

Total 42 4965 2078 1622 470 578 9755(0.43) (50.60) (21.30) (16.63) (4.82) (5.93)

Tables 11-3-2 through 11-3-19: Results are given as frequencies and percents.(%)

Table 11-2.28. Tumor size and microscopic lymph node metastasis (12'h edition) (single cancer)Tumor size Unknown NO N1 N2 N3 N4 Total

Small 87 2183 292 143 17 18 2740(3.18) (79.67) (10.66) (5.22) (0.62) (0.66) (28.09)

Medium 334 1374 992 1001 273 151 4125(8.10) (33.31) (24.05) (24.27) (6.62) (3.66) (42.29)

Large 362 438 652 906 266 266 2890(12.53) (15.16) (22.56) (31.35) (9.20) (9.20) (29.63)

Total 783 3995 1936 2050 556 435 9755(8.03) (40.95) (9.85) (21.01) (5.70) (4.46)

a Small, <4cm diameter; Medium, ~4 to 8cm; Large, >8cm.(%)

Table 11-2.29. Tumor size and macroscopic lymph node metastasis (13th edition) (singlecancer)Tumor size Unknown NO N1 N2 N3 M Total

Small 16 2415 209 68 30 2 2740(0.58) (88.14) (7.63) (2.48) (1.09) (0.07) (28.09)

Medium 64 1861 959 798 408 35 4125(1.55) (45.12) (23.25) (19.35) (9.89) (0.85) (42.29)

Large 92 689 819 772 455 63 2890(3.18) (23.84) (28.34) (26.71) (15.74) (2.18) (29.63)

Total 172 4965 1987 1638 893 100 9755(1.76) (50.90) (20.37) (16.79) (9.15) (1.03)

(%)


Table 11-2.30. Tumor size and microscopic lymph node metastasis (13th edition) (singlecancer)

Parameter Unknown NO N1 N2 N3 M Total

Tumor size

Small 87 2183 294 143 32 1 2740(3.18) (79.67) (10.73) (5.22) (1.17) (0.04) (28.09)

Medium 334 1374 1004 1022 352 39 4125(8.10) (33.31) (24.34) (24.78) (8.53) (0.95) (42.29)

Large 362 438 664 901 438 87 2890(12.53) (15.16) (22.98) (31.18) (15.16) (3.01) (29.63)

Total 783 3995 1962 2066 822 127 9755(8.03) (40.95) (20.11) (21.18) (8.43) (1.30)

Microscopic lymph node metastasis

<10 10 199 1 2 1 0 213(4.69) (93.43) (0.47) (0.94) (0.47) (0) (2.18)

10-20 34 871 48 9 4 0 966(3.52) (90.17) (4.97) (0.93) (0.41) (0) (9.90)

20--40 61 1540 387 238 59 2 2287(2.67) (67.34) (16.92) (10.41 ) (2.58) (0.09) (23.44)

40--60 178 681 557 564 198 25 2203(8.08) (30.91) (25.28) (25.60) (8.99) (1.13) (22.09)

60-80 219 393 476 569 221 24 1902(11.51) (20.66) (25.03) (29.92) (11.62) (1.26) (19.50)

>80 281 311 493 684 339 76 2184(12.87) (14.24) (22.57) (31.32) (15.52) (3.48) (22.39)

Total 783 3995 1962 2066 822 127 9755(8.02) (40.95) (20.11) (21.18) (8.43) (1.30)

(%)

Table 11-2.31. Tumor location and macroscopic lymph node metastasis (12th edition) (singlecancer)

Tumor site Unknown NO N1 N2 N3 N4 Total

Cardia 6 149 184 225 42 119 725(0.83) (20.55) (25.38) (31.03) (5.79) (16.41) (7.43)

Upper 3 610 163 136 6 59 977(0.31) (62.44) (16.68) (13.92) (0.61) (6.04) (10.01 )

Middle 8 2321 570 367 42 112 3420(0.23) (67.87) (16.67) (10.73) (1.23) (3.27) (35.06)

Lower 6 1628 823 604 310 167 3538(0.17) (46.01) (23.26) (17.07) (8.76) (4.72) (36.27)

Whole 19 257 338 290 70 121 1095(1.74) (23.47) (30.87) (26.48) (6.39) (11.05) (11.23)

Total 42 4965 2078 1622 470 578 9755(0.43) (50.90) (21.30) (16.63) (4.82) (5.93)

(%)


Table 11-2.32. Tumor location and microscopic lymph node metastasis (12th edition) (singlecancer)

Tumor site Unknown NO N1 N2 N3 N4 Total

Cardia 48 103 128 256 77 113 725(6.62) (14.21) (17.66) (35.31) (10.62) (15.59) (7.43)

Upper 48 521 143 205 12 48 977(4.91) (53.33) (14.64) (20.98) (1.23) (4.91 ) (10.02)

Middle 174 1986 606 523 50 81 3420(5.09) (58.07) (17.72) (15.29) (1.46) (2.37) (35.06)

Lower 343 1232 798 736 337 92 3538(9.69) (34.82) (22.56) (20.80) (9.53) (2.60) (36.27)

Whole 170 153 261 330 80 101 1095(15.53) (13.97) (23.84) (30.14) (7.31) (9.22) (11.23)

Total 783 3995 1936 2050 556 435 9755(8.03) (40.95) (19.84) (21.01) (5.70) (4.46)

(%)


Tumor site Unknown NO N1 N2 N3 M Total

Cardia 17 149 178 209 144 28 725(2.34) (20.55) (24.55) (28.83) (19.86) (3.86) (7.43)

Upper 14 610 153 113 68 19 977(1.43) (62.44) (15.66) (11.57) (6.96) (1.94) (10.01)

Middle 33 2321 551 341 166 8 3420(0.96) (67.87) (16.11) (9.97) (4.85) (0.23) (35.06)

Lower 67 1628 781 678 361 23 3538(1.89) (46.01) (22.07) (19.16) (10.20) (0.65) (36.27)

Whole 41 257 324 297 154 22 1095(3.74) (23.47) (29.59) (27.12) (14.06) (2.01) (11.23)

Total 172 4965 1987 1638 893 100 9755(1.76) (50.90) (20.37) (16.79) (9.15) (1.03)

(%)


Tumor site Unknown NO N1 N2 N3 M Total

Cardia 48 103 128 240 164 42 725(6.62) (14.21) (17.66) (33.10) (22.62) (5.79) (7.43)

Upper 48 521 143 173 70 22 977(4.91) (53.33) (14.64) (17.71) (7.16) (2.25) (10.01)

Middle 174 1986 606 502 144 8 3420(5.09) (58.07) (17.72) (14.68) (4.21) (0.23) (35.06)

Lower 343 1232 824 803 309 27 3538(9.69) (34.82) (23.29) (22.70) (8.73) (0.76) (36.27)

Whole 170 153 261 348 135 28 1095(15.53) (13.97) (23.84) (31.78) (12.33) (2.56) (11.23)

Total 783 3995 1962 2066 822 127 9755(8.03) (40.95) (20.11) (21.18) (8.43) (1.30)

(%)


Table 11-2.35. Tumor types and macroscopic lymph node metastasis (12lh edition) (singlecancer)Tumor type Unknown NO N1 N2 N3 N4 Total

0 1 2892 125 22 6 5 3051(0.03) (94.79) (4.10) (0.72) (0.20) (0.16) (31.27)

0 71 46 19 6 6 148(0) (47.97) (31.08) (12.84) (4.05) (4.05) (1.52)

2 1 546 538 410 145 118 1758(0.06) (31.06) (30.60) (23.32) (8.25) (6.71) (18.02)

3 15 824 802 737 223 267 2868(0.52) (28.73) (27.96) (25.70) (7.78) (9.31) (29.40)

4 23 297 401 354 73 151 1299(1.77) (22.86) (30.87) (27.25) (5.62) (11.62) (13.32)

5 2 335 166 80 17 31 631(0.32) (53.09) (26.31) (12.68) (2.69) (4.91) (6.47)

Total 42 4965 2078 1622 470 578 9755(0.43) (50.90) (21.30) (16.63) (4.82) (5.93)

(%)

Table 11-2.36. Tumor types and microscopic lymph node metastasis (12th edition) (singlecancer)Tumor type Unknown NO N1 N2 N3 N4 Total

0 83 2647 219 93 6 3 3051(2.72) (86.76) (7.18) (3.05) (0.20) (0.10) (31.28)

5 61 42 33 5 2 148(3.38) (41.22) (28.38) (22.30) (3.38) (1.35) (1.52)

2 149 434 522 440 138 75 1758(8.48) (24.69) (29.69) (25.03) (7.85) (4.27) (18.02)

3 347 462 698 898 274 189 2868(12.10) (16.11) (24.34) (31.31) (9.55) (6.59) (29.40)

4 177 151 276 446 108 141 1299(13.63) (11.62) (21.25) (34.33) (8.31) (10.85) (13.32)

5 22 240 179 140 25 25 631(3.49) (38.03) (28.37) (22.19) (3.96) (3.96) (6.47)

Total 783 3995 1936 2050 556 435 9755(8.02) (40.95) (19.85) (21.01) (5.70) (4.46)

(%)

Table 11-2.37. Tumor types and macroscopic lymph node metastasis (13th edition) (singlecancer)Tumor type Unknown NO N1 N2 N3 M Total

0 7 2892 121 21 10 0 3051(0.23) (94.79) (3.97) (0.69) (0.33) (0) (31.28)

4 71 43 20 9 1 148(2.70) (47.97) (29.05) (13.51) (6.08) (0.68) (1.52)

2 23 546 519 432 220 18 1758(1.31) (31.06) (29.52) (24.57) (12.51) (1.02) (18.02)

3 60 824 774 747 419 44 2868(2.09) (28.73) (26.99) (26.05) (14.61) (1.53) (29.40)

4 61 297 374 345 189 33 1299(4.70) (22.86) (28.79) (26.56) (14.55) (2.54) (13.32)

5 17 335 156 73 46 4 631(2.69) (53.09) (24.72) (11.57) (7.29) (0.63) (6.47)

Total 172 4965 1987 1638 893 100 9755(1.76) (50.90) (20.37) (16.79) (9.15) (1.03)

(%)


Table 11-2.38. Tumor types and microscopic lymph node metastasis (13th edition) (single

cancer) .

Tumor type Unknown NO N1 N2 N3 M Total

0 83 2647 220 95 6 0 3051(2.72) (86.76) (7.21) (3.11 ) (0.20) (0) (31.28)

5 61 42 34 5 1 148(3.38) (41.22) (28.38) (22.97) (3.38) (0.68) (1.52)

2 149 434 528 464 167 16 1758(8.48) (24.69) (30.03) (26.39) (9.50) (0.91) (18.02)

3 347 462 710 895 400 54 2868(12.10) (16.11) (24.76) (31.21) (13.95) (1.88) (29.40)

4 177 151 282 444 191 54 1299(13.63) (11.62) (21.71) (34.18) (14.70) (4.16) (13.32)

5 22 240 180 134 53 2 631(3.49) (38.03) (28.53) (21.24) (8.40) (0.32) (6.47)

Total 783 3995 1962 2066 822 127 9755(8.03) (40.95) (20.11) (21.18) (8.43) (1.30)

(%)

Table 11-2.39. Tumor location and cell types

Tumor site Unknown Differ. Undiff. Misc. Total

Cardia 14 331 353 27 725(46.55) (49.65) (3.80) (7.43)

Upper 26 442 502 7 977(46.48) (52.79) (0.74) (10.01)

Middle 77 1386 1949 8 3420(41.46) (58.30) (0.24) (35.06)

Lower 64 1928 1530 16 3538(55.50) (44.04) (0.46) (36.27)

Whole 6 238 845 6 1095(21.85) (77.59) (0.55) (11.23)

Total 187 4325 5179 64 9755(1.92) (44.34) (53.09) (0.66)

(%)

Table 11·2.40. Correlation of lymph node metastasis between Japanese Rules (13th edition)and TNM classification (single cancer)

Japanese Rules TNM classification Total

Unknown NO N1 N2 N3

Unknown 301 15 368 79 20 783(38.44) (1.92) (47.00) (10.09) (2.55) (8.03)

NO 12 3983 0 0 0 3995(0.30) (99.70) (0) (0) (0) (40.95)

N1 0 0 1767 188 7 1962(0) (0) (90.06) (9.58) (0.36) (20.11)

N2 0 0 1034 892 140 2066(0) (0) (50.05) (43.18) (6.78) (21.52)

N3 0 0 165 428 229 822(0) (0) (20.07) (52.07) (27.86) (8.43)

M 0 0 12 38 77 127(0) (0) (9.45) (29.92) (60.63) (1.30)

Total 313 3998 3346 1625 473 9755(3.21 ) (40.98) (34.30) (16.66) (4.85)

(%)


Table 11-2.41. Wall invasion and microscopic lymph node metastasis (13th edition) (singlecancer)

Wall invasion Lymph node metastasis Total

Unknown NO Nl N2 N3 M

Unknown 86 47 13 7 11 3 167(51.50) (28.14) (7.78) (4.19) (6.59) (1.80) (1.71)

M 18 1564 27 10 0 0 1619(1.11 ) (96.60) (1.67) (0.62) (0) (0) (16.60)

SM 8 1017 192 80 8 1 1306(0.61) (77.87) (14.70) (6.13) (0.61) (0.08) (13.39)

MP 14 436 272 152 41 1 916(1.53) (47.60) (29.69) (16.59) (4.48) (0.11) (9.39)

SS 142 537 612 568 188 20 2067(6.87) (25.98) (29.61 ) (27.48) (9.10) (0.97) (21.19)

SE 480 376 807 1151 493 74 3381(14.20) (11.12) (23.87) (34.04) (14.58) (2.19) (34.66)

SI-SEI 35 18 39 98 81 28 299(11.71) (6.02) (13.04) (32.78) (27.09) (9.36) (3.07)

Total 783 3995 1962 2066 822 127 9755(8.03) (40.95) (20.11) (21.18) (8.43) (1.30)

(%)

Table 11-2.42. Lymph node metastasis to each site according to the location of a single primary tumor

Primary No.1 No.2 No.3 No.4Sa No.4Sb No.4d No.5

Cardia 3641730 3651747 4881727 491703 1091727 190/676 42/591(0.50) (0.49) (0.67) (0.07) (0.15) (0.28) (0.00)

Upper 186/1120 147/989 398/1128 21/914 79/1038 142/1043 16/886(0.17) (0.15) (0.35) (0.02) (0.08) (0.14) (0.00)

Lower 49017122 93/1413 268517623 2211186 153/5389 2043/7599 37917254(0.07) (0.07) (0.35) (0.02) (0.03) (0.27) (0.00)

Whole 785/8107 274/2206 3470/8677 82/1922 321/6277 2701/8667 498/8254(0.10) (0.12) (0.40) (0.04) (0.05) (0.31) (0.00)

Primary NO.6 No.7 No.8a NO.9 No. 10 No. 11 No.12P

Cardia 111/573 2391717 112/631 2491707 209/684 236/673 22/211(0.19) (0.33) (0.18) (0.35) (0.31) (0.35) (0.10)

Upper 55/869 13511108 48/1011 11711061 124/783 121/875 7/412(0.06) (0.12) (0.05) (0.11) (0.16) (0.14) (0.02)

Lower 243717530 80517278 119917154 83617122 151/1084 203/3049 144/3919(0.32) (0.11) (0.17) (0.12) (0.14) (0.07) (0.04)

Whole 3030/8603 1127/8239 1476/8062 1123/8032 350/1741 373/3708 186/4485(0.35) (0.14) (0.18) (0.14) (0.20) (0.10) (0.04)

Primary No.12b No. 8p + 13 No. 14 No. 15 No. 16 No. 104 No. 108 + 110 No. 111

Cardia 11/96 29/191 23/109 8/28 126/294 4/12 86/326 20/145(0.11) (0.15) (0.21) (0.29) (0.43) (0.33) (0.26) (0.14)

Upper 3/156 13/306 11/163 4/22 55/283 3/9 4/66 4/86(0.02) (0.04) (0.07) (0.18) (0.19) (0.33) (0.06) (0.05)

Lower 116/1929 222/2611 205/1775 24/212 173/653 11/30 7/59 10/118(0.06) (0.09) (0.12) (0.11 ) (0.26) (0.37) (0.12) (0.08)

Whole 143/2262 294/3099 264/2087 44/300 272/929 12/35 14/100 181163(0.06) (0.09) (0.13) (0.15) (0.29) (0.34) (0.14) (0.11)

Results are given us frequencies and ratios.Lymph node sites: 1, right paracardial LN; 2,left paracardial LN; 3, LN along the lesser curvature; 4sa, LN along the short gastric vessels; 4sb,LN along the left gastroepiploic vessels; 4d, LN along the right gastroepiploic vessels; 5 + 12a, suprapyloric LN; 6, infrapyloric LN; 7, LN alongthe left gastric artery; 8a, LN along the common hepatic artery (anterosuperior group); 9, LN around the celiac artery; 10, LN at the splenichilum; IIp + d, LN along the splenic artery; 12p, LN in the hepatoduodenalligament (behind the portal vein); 12b, LN in the hepatoduodenalligament (along the bile duct); 13 + 8p, LN on the posterior surface of the pancreas; 14v + a, LN along superior mesenteric vessels; 15, LNalong the middle colic vessels; 16, LN around the abdominal aorta; 108 + 110, paraesophageal LN in the middle and lower thorax; Ill, supra-diaphragmatic LN; 104, supraclavicular LN.


Table 11-2.43. Tumor types and peritoneal dissemination Table 11-2.44. Tumor types and liver metastasis

Tumor type Unknown PO PI P2 P3 Total Tumor type Unknown HO HI H2 H3 Total

0 1 3050 0 0 0 3051 0 8 3043 0 0 0 3051(0.03) (99.97) (0) (0) (0) (31.28) (0.26) (99.74) (0) (0) (0) (31.28)

0 143 1 2 2 148 0 137 7 3 1 148(0) (96.62) (0.68) (1.35) (1.35) (1.52) (0) (92.57) (4.73) (2.03) (0.68) (1.52)

2 0 1696 26 31 5 1758 2 0 1591 50 74 43 1758(0) (96.47) (1.48) (1.76) (0.28) (18.02) (0) (90.50) (2.84) (4.21) (2.45) (18.02)

3 0 2342 143 281 102 2868 3 0 2719 43 52 54 2868(0) (81.66) (4.99) (9.80) (3.56) (29.40) (0) (94.80) (1.50) (1.81 ) (1.88) (29.40)

4 0 896 109 201 93 1299 4 0 1280 9 6 4 1299(0) (68.98) (8.39) (15.47) (7.16) (13.32) (0) (98.54) (0.69) (0.46) (0.31 ) (13.32)

5 0 597 9 15 10 631 5 0 621 1 4 5 631(0) (94.61 ) (1.43) (2.38) (1.58) (6.47) (0) (98.42) (0.16) (0.63) (0.79) (6.47)

Total 1 8724 288 530 212 9755 Total 8 9391 110 139 107 9755(0.010) (89.43) (2.95) (5.43) (2.17) (0.08) (96.27) (Ll3) (1.42) (LlO)

(%) (%)

3. Diagnosis

Table 11-3.1. Diagnostic factors, all Table 11-3.3. Preoperative tumorcases type of early cancer, all cases

Preoperative Frequency % Tumor type Frequency %diagnosis

Advanced 8582Unknown 19 0.2 I 130 3.4Cancer 12137 97.7 lIa 307 8.0Ulcer 186 1.5 lIa + lIc 359 9.4Atypia 27 0.2 lIb 17 0.4Polyp 23 0.2 lIc 2374 61.9Submucosal 1 0.0 III 59 1.5

tumor lIc + III 579 15.1Sarcoma 10 0.1 Miscellaneous 12 0.3Cancer of 16 0.1 12419

other organ

12419

Table 11-3.2. Preoperative tumor Table 11-3.4. Preoperative estimatedtypes, all cases depth of wall invasion

Tumor type Frequency % Depth Frequency %

Unknown 744 No descriptin 1648 13.3Superficial 3550 30.4 Mucosal 1190 9.6Localized 2619 22.4 Submucosal 2516 20.3Intermediate 772 6.6 Musc prop 590 4.8Infiltrative 4452 38.1 Subserosa 1 25 0.2Semiearly 282 2.4 Subserosa 2 161 1.3

12419 Subserosa 3 1291 10.4Serosal 3031 24.4Invading 1232 9.9Conteguous 735 5.9

12419


Table 11-3.5. Microscopic lymph node metastasis in superficial cancer (13th edition), singlecancer lesion

Cancer type Unknown NO Nl N2 N3 M Total

Advanced 691 1143 1607 1884 789 125 6239(unknown) (63.96)

2 104 14 4 3 0 127(1.57) (81.89) (11.02) (3.15) (2.36) (0) (1.30)

[Ja 5 213 32 17 1 0 268(1.87) (79.48) (11.94) (6.34) (0.37) (0) (2.75)

IIa + lIe 11 216 40 21 2 0 290(3.79) (74.48) (13.79) (7.24) (0.69) (0) (2.97)

lIb 3 30 4 2 3 0 42(7.14) (71.43) (9.52) (4.76) (7.14) (0) (0.43)

lIe 58 1861 203 98 17 2 2239(2.59) (83.12) (9.07) (4.38) (0.76) (9) (22.95)

III 2 28 1 0 0 0 31(6.45) (90.32) (3.23) (0) (0) (0) (0.32)

lIe + III 11 387 60 40 5 0 503(2.19) (76.94) (11.93) (7.95) (0.99) (0) (5.16)

Misc. 0 13 1 0 2 0 16(0) (81.25) (6.25) (0) (12.50) (0) (0.16)

Total 783 3995 1962 2066 822 127 9755(8.03) (40.95) (20.11 ) (21.18) (8.43) (1.30)

Results in Tables 11-4.5 through 11-4.15 are frequencies and percents.(%)

Table 11-3.6. Macroscopic superficial cancer and histologic wall invasion, single cancer lesion

Cancer type Unknown M SM MP SS SE SI-SEI Total

Advanced 55 32 130 597 1864 3263 298 6239(unknown) (63.96)

4 55 56 8 1 3 0 127(3.15) (43.31) (44.09) (6.30) (0.79) (2.36) (0) (1.30)

lJa 6 146 76 17 14 8 1 268(2.24) (54.48) (28.36) (6.34) (5.22) (2.99) (0.37) (2.75)

IIa + lIe 15 83 145 30 13 4 0 290(5.17) (28.62) (50.00) (10.34) (4.48) (1.38) (0) (2.97)

lIb 0 23 6 6 4 3 0 42(0) (54.76) (14.29) (14.29) (9.52) (7.14) (0) (0.43)

lIe 82 1097 702 176 106 76 0 2239(3.66) (49.00) (31.35) (7.86) (4.73) (3.39) (0) (22.95)

III 0 13 11 5 2 0 0 31(0) (41.94) (35.48) (16.13) (6.45) (0) (0) (0.32)

lIe + III 5 168 171 74 62 23 0 503(0.99) (33.40) (34.00) (14.71) (12.33) (4.57) (0) (5.16)

Misc. 0 2 9 3 1 1 0 16(0) (12.50) (56.25) (18.75) (6.25) (6.25) (0) (0.16)

Total 167 1619 1306 916 2067 3381 299 9755(1.71 ) (16.60) (13.39) (9.39) (21.19) (34.66) (3.07)

(%)

Background Factor· Diagnosis 227

Table 11-3.7. Tumor types and histologic wall invasion, single cancer/lesion, single cancerlesionTumor type Unknown M SM MP SS SE SI-SEI Total

0 105 1572 1104 179 75 16 0 3051(3.44) (51.52) (36.18) (5.87) (2.46) (0.52) (0) (31.28)

2 3 22 40 45 34 2 148

(1.35) (2.03) (14.86) (27.03) (30.41 ) (22.97) (1.35) (1.52)

2 16 1 37 240 837 556 71 1758(0.91) (0.06) (2.10) (13.65) (47.61) (31.63) (4.04) (18.02)

3 27 19 69 276 772 1580 125 2868(0.94) (0.66) (2.41) (9.62) (26.92) (55.09) (4.36) (29.40)

4 8 3 7 24 145 1015 97 1299(0.62) (0.23) (0.54) (1.85) (11.16) (78.14) (7.47) (13.32)

5 9 21 67 157 193 180 4 631(1.43) (3.33) (10.62) (24.88) (30.59) (28.53) (0.63) (6.47)

Total 167 1619 1306 916 2067 3381 299 9755(1.71) (16.60) (13.39) (9.39) (21.19) (34.66) (3.07)

(%)

Table 11-3.8. Macroscopic tumor types and gross appearance of serosa, single cancer lesionTumor Unknown Normal Cicatricial Nodulated Granulated Tendon- Furs- Inflammatory Misc. Totaltype like like

0 3 2737 288 0 3 1 0 15 4 3051(0.10) (89.71) (9.44) (0.00) (0.10) (0.03) (0) (0.49) (0.13) (31.28)

2 46 48 17 14 1 7 8 5 148(1.35) (31.08) (32.43) (11.49) (9.46) (0.68) (4.73) (5.41) (3.38) (1.52)

2 9 192 657 326 247 36 113 138 40 1758(0.51) (10.92) (37.37) (18.54) (14.05) (2.05) (6.43) (7.85) (2.28) (18.02)

3 25 316 594 134 408 252 966 94 79 2868(0.87) (11.02) (20.71 ) (4.67) (14.23) (8.79) (33.68) (3.28) (2.75) (29.40)

4 3 42 83 8 78 542 500 8 35 1299(0.23) (3.23) (6.39) (0.62) (6.00) (41.72) (38.49) (0.62) (2.69) (13.32)

5 2 257 175 25 41 37 63 15 16 631(0.32) (40.73) (27.73) (3.96) (6.50) (5.86) (9.98) (2.38) (2.54) (6.47)

Total 44 3590 1845 510 791 869 1649 278 179 9755(0.45) (36.80) (18.91) (5.23) (8.11) (8.91) (16.90) (2.85) (1.83)

(%)


Table 11-3.9. Gross appearance of serosa and histologic wall invasion, single cancer lesion

Gross Unknown M SM MP SS SE SI-SEI Totalappearance

Unknown 1 2 2 3 11 17 8 44(2.27) (4.55) (4.55) (6.82) (25.00) (38.64) (18.18) (0.45)

Normal 124 1469 1134 494 269 99 1 3590(3.45) (40.92) (31.59) (13.76) (7.49) (2.76) (0.03) (36.80)

Cicatricial 11 136 148 242 728 529 51 1845(0.60) (7.37) (8.02) (13.12) (39.46) (28.67) (2.76) (18.91)

Nodulated 6 0 1 44 211 223 25 510(1.18) (0) (0.20) (8.63) (41.37) (43.73) (4.90) (5.23)

Granulated 1 0 4 35 241 481 29 791(0.13) (0) (0.51) (4.42) (30.47) (60.81) (3.67) (8.11 )

Tendon-like 6 1 2 12 110 658 80 869(0.69) (0.12) (0.23) (1.38) (12.66) (75.72) (9.21) (8.91 )

Furslike 10 3 0 27 314 1209 86 1649(0.61 ) (0.18) (0) (1.64) (19.04) (73.32) (5.22) (16.90)

Inflammatory 3 8 9 37 142 68 11 278(1.08) (2.88) (3.24) (13.31) (51.08) (24.46) (3.96) (2.85)

Misc. 5 0 6 22 41 97 8 179(2.79) (0) (3.35) (12.29) (22.91) (54.19) (4.47) (1.83)

Total 167 1619 1306 916 2067 3381 299 9755(1.71) (16.60) (13.39) (9.39) (21.19) (34.66) (3.07)

(%)

Table 11-3.10. Histologic wall invasion and abdominal lavage cytology, single cancer lesion

Wall Abdominal lavage cytologyinvasion Unknown Not done Class 1 Class 2 Class 3 Class 4 Class 5 Total

Unknown 2 147 9 0 0 0 9 167(1.20) (88.02) (5.39) (0) (0) (0) (5.39) (1.71)

M 16 1597 4 1 0 0 1 1619(0.99) (98.64) (0.25) (0.06) (0) (0) (0.06) (16.60)

SM 15 1272 11 6 0 2 0 1306(1.15) (97.40) (0:84) (0.46) (0) (0.15) (0) (13.39)

MP 6 876 27 5 1 1 0 916(0.66) (95.63) (2.95) (0.55) (0.11) (0.11) (0) (9.39)

SS 14 1928 94 15 7 2 7 2067(0.68) (93.28) (4.55) (0.73) (0.34) (0.10) (0.34) (21.19)

SE 42 2849 198 96 20 38 138 3381(1.24) (84.27) (5.86) (2.84) (0.59) (1.12) (4.08) (34.66)

Sl-SEI 2 240 21 1 1 2 32 299(0.67) (80.27) (7.02) (0.33) (0.33) (0.67) (10.70) (3.07)

Total 97 8909 364 124 29 45 187 9755

(0.99) (91.33) (3.73) (1.27)

(%)

Appendix: Database of CIH (Cancer Institute Hospital) 229

Table 11-3.11. Macroscopic tumor types and lavage cytology, single cancer lesionTumor type Lavage cytology

Unknown Not done Class 1 Class 2 Class 3 Class 4 Class 5 Total

0 34 3002 6 5 1 2 1 3051(1.11) (98.39) (0.20) (0.16) (0.03) (0.07) (0.03) (31.28)

2 140 5 0 0 1 0 148(1.35) (94.59) (3.38) (0) (0) (0.68) (0) (1.52)

2 15 1611 71 33 9 9 10 1758(0.85) (91.64) (4.04) (1.88) (0.51) (0.51 ) (0.57) (18.02)

3 27 2523 178 44 9 16 71 2868(0.94) (87.97) (6.21) (1.53) (0.31) (0.56) (2.48) (29.40)

4 12 1048 80 36 9 17 97 1299(0.92) (80.68) (6.16) (2.77) (0.69) (1.31) (7.47) (13.32)

5 7 585 24 6 1 0 8 631(1.11) (92.71 ) (3.80) (0.95) (0.16) (0) (1.27) (6.47)

Total 97 8909 364 124 29 45 187 9755(0.99) (91.33) (3.73) (1.27) (0.30) (0.46) (1.92)

(%)

Table 11-3.12. Macroscopic abdominal dissemination and lavage cytology, single cancer lesionDissemination Lavage cytology

Unknown Not done Class 1 Class 2 Class 3 Class 4 Class 5 Total

Unknown 0 1 0 0 0 0 0 1(0) (100.00) (0) (0) (0) (0) (0) (0.010)

PO 87 8086 318 104 23 31 75 8724(1.00) (92.69) (3.65) (1.19) (0.26) (0.36) (0.86) (89.43)

PI 4 237 17 8 2 3 17 288(1.39) (82.29) (5.90) (2.78) (0.69) (1.04) (5.90) (2.95)

P2 4 435 20 9 3 8 51 530(0.75) (82.08) (3.77) (1.70) (0.57) (1.51 ) (9.62) (5.43)

P3 2 150 9 3 1 3 44 212(0.94) (70.75) (4.25) (1.42) (0.47) (1.42) (20.75) (2.17)

Total 97 8909 364 124 29 45 187 9755(0.99) (91.33) (3.73) (1.27) (0.30) (0.46) (1.92)

(%)

Table 11-3.13. Correlation between macroscopic and microscopic lymph node metastasis (12th

edition), single cancer lesionMacroscopic type Microscopic type

Unknown NO Nl N2 N3 N4 Total

Unknown 42 0 0 0 0 0 42(100.00) (0) (0) (0) (0) (0) (0.43)

NO 97 3833 673 324 35 3 4965(1.95) (77.20) (13.55) (6.53) (0.70) (0.06) (50.90)

Nl 158 132 1153 546 70 19 2078(7.60) (6.35) (55.49) (26.28) (3.37) (0.91 ) (21.30)

N2 210 25 69 1134 133 51 1622(12.95) (1.54) (4.25) (69.91) (8.20) (3.14) (16.63)

N3 99 4 19 22 309 17 470(21.06) (0.85) (4.04) (4.68) (65.74) (3.62) (4.82)

N4 177 1 22 24 9 345 578(30.62) (0.17) (3.81) (4.15) (1.56) (59.69) (5.92)

Total 783 3995 1936 2050 556 435 9755(8.03) (40.95) (19.85) (21.01) (5.70) (4.46)

(%)


Table 11-3.14. Correlation between macroscopic and microscopic lymph node metastasis (13th


Unknown NO Nl N2 N3 M Total

Unknown 76 0 56 32 7 1 172(44.19) (0) (32.56) (18.60) (4.07) (0.58) (1.76)

NO 97 3833 680 318 33 4 4965(1.95) (77.20) (13.70) (6.40) (0.66) (0.08) (50.90)

Nl 142 132 1114 518 72 9 1987(7.15) (6.64) (56.06) (26.07) (3.62) (0.45) (20.37)

N2 217 26 71 1141 154 29 1638(13.25) (1.59) (4.33) (69.66) (9.40) (1.77) (16.79)

N3 230 4 39 54 549 17 893(25.76) (0.45) (4.37) (6.05) (61.48) (1.90) (9.15)

N4 21 0 2 3 7 67 100(21.00) (0) (2.00) (3.00) (7.00) (67.00) (1.03)

Total 783 3995 1962 2066 822 127 9755(8.03) (40.95) (20.11) (21.18) (8.43) (1.30)

(%)

Table 11-3.15. Relationship between macroscopic and microscopic stage classification (12th


Ia Ib II IlIa llIb IVa IVb Total

Ia 2893 319 85 20 2 0 1 3320(87.14) (9.61) (2.56) (0.60) (0.06) (0) (0.03) (32.54)

Ib 225 841 439 180 53 7 1 1746(12.89) (48.17) (25.14) (10.31) (3.04) (0.40) (0.06) (17.11)

II 23 190 649 371 168 20 2 1423(1.62) (13.35) (45.61) (26.07) (11.81) (1.41) (0.14) (13.95)

llIa 4 41 207 605 338 53 25 1273(0.31) (3.22) (16.26) (47.53) (26.55) (4.16) (1.96) (12.48)

llIb 0 10 40 171 459 88 33 801(0) (1.25) (4.99) (21.35) (57.30) (10.99) (4.12) (7.85)

IVa 0 2 7 36 139 294 55 533(0) (0.38) (1.31) (6.75) (26.08) (55.16) (10.32) (5.22)

IVb 2 2 3 13 20 104 964 1108(0.18) (0.18) (0.27) (1.17) (1.81) (9.39) (87.00) (10.86)

Total 3147 1405 1430 1396 1179 566 1081 10204(30.84) (13.77) (14.01) (13.68) (11.55) (5.55) (10.59) (100.00)

(%)

Background Factor· Diagnosis 231

Table 11-3.16. Relationship between macroscopic and microscopic stage classification (13th

edition), single cancer lesion

Macroscopic type Microscopic type

Ia Ib II IIIa IIIb IV Total

Ia 2893 319 86 19 2 1 3320(87.14) (9.61) (2.59) (0.57) (0.06) (0.03) (32.54)

Ib 225 842 443 177 40 19 1746(12.89) (48.22) (25.37) (10.14) (2.29) (1.09) (17.11)

II 22 190 651 378 147 39 1427(1.54) (13.31 ) (45.62) (26.49) (10.30) (2.73) (13.98)

IlIa 2 42 210 614 309 106 1283(0.16) (3.27) (16.37) (47.86) (24.08) (8.26) (12.57)

IIIb 0 8 37 170 386 94 695(0) (1.15) (5.32) (24.46) (55.54) (13.53) (6.81 )

IV 5 4 10 44 118 1552 1733(0.29) (0.23) (0.58) (2.54) (6.81) (89.56) (16.98)

Total 3147 1405 1437 1402 1002 1811 10204(30.84) (13.77) (14.08) (13.74) (9.82) (17.75) (100.0)

(%)

Table 11-3.17. Preoperative and histologic wall invasion, single cancer lesion

Preoperative assessment Histologic wall invasion

Unknown M SM MP SS SE SI-SEI Total

Unknown 23 15 80 380 1136 2091 31 3756(0.61) (0.40) (2.13) (10.12) (30.24) (55.67) (0.83) (38.50)

M 56 641 223 28 10 0 0 958(5.85) (66.91) (23.28) (2.92) (1.04) (0) (0) (9.82)

SM 48 925 870 131 62 15 0 2051(2.34) (45.10) (42.42) (6.39) (3.02) (0.73) (0) (21.03)

MP 12 30 109 196 101 26 0 474(2.53) (6.33) (23.00) (41.35) (21.31) (5.49) (0) (4.86)

SS 16 8 22 171 609 425 21 1272(1.26) (0.63) (1.73) (13.44) (47.88) (33.41) (1.65) (13.04)

SI-SEI 12 0 2 10 149 824 247 1244(0.96) (0) (0.16) (0.80) (11.98) (66.24) (19.86) (12.75)

Total 167 1619 1306 916 2067 3381 299 9755(1.71) (16.00) (13.39) (9.39) (21.19) (34.66) (3.07)

(%)


4. Pathology

Table 11-4.1. Pathological factors, single cancer lesion

Parameter Frequency % Parameter Frequency %

Cell type (JGCA classification) Hematogenous metastasis

No report 187 1.9 None 9015 92.4

pap 1342 13.8 Liver 537 5.5

tub1 970 9.9 Lung 154 1.6

tub2 2013 20.6 Bone 28 0.3

por 3213 32.9 Brain 6 0.1

muc 297 3.0 Skin 9 0.1

sig 1669 17.1 Misc. 6 0.1

as 34 0.3 9755sq 23 0.2ud 4 0.0 Local recurrence

misc. 3 0.0 None 9297 95.3

9755 Perigastric 321 3.3Liver hilus 110 1.1

Cell differentiation Abdominal wall 20 0.2

187 1.9 Misc. 7 0.1

Differentiated 4325 44.3 9755Undifferentiated 5243 53.7

Remnant stomach9755

None 9692 99.4Cause of death Stoma 29 0.3

17 Stump 34 0.3

Alive 4307 44.2 9755Relapse 2842 29.2Other cancer 34 0.3 Distant metastasis

Noncancer death 625 6.4 None 9414 96.5Unknown 1767 18.1 Virchow 79 0.8Direct death 163 1.7 Inguinal 8 0.1

9755 Pulmonary lymphangitis 15 0.2Paraaorta 239 2.5

Peritoneal dissemination9755

None 8618 88.3Knobby 138 1.4 Miscellaneous relapse

Disseminated 883 9.1 Noreport 2Kruckenberg 21 0.2 No 9725 99.7Douglas 95 1.0 Yes 28 0.3

9755 9755

Table 11-4.2. Histologic cell types and microscopic lymph node metastasis (12th edition),

single cancer lesion

Cell type LN metastasis

Unknown NO N1 N2 N3 N4 Total

No report 89 53 20 12 6 7 187(47.59) (28.34) (10.70) (6.42) (3.21) (3.74) (1.91 )

pap 127 418 334 298 108 57 1342(9.46) (31.15) (24.89) (22.21) (8.05) (4.25) (13.76)

tub1 15 673 122 106 31 23 970(1.55) (69.38) (12.58) (10.93) (3.20) (2.37) (9.94)

tub2 192 788 412 433 131 57 2013(9.54) (39.15) (20.47) (21.51) (6.51 ) (2.83) (20.63)

por 270 976 718 866 213 170 3213(8.40) (30.38) (22.35) (26.95) (6.63) (5.29) (32.94)

muc 35 57 88 90 16 11 297(11.78) (19.19) (29.63) (30.30) (5.39) (3.70) (3.04)

sig 51 1014 224 228 50 102 1669(3.06) (60.75) (13.42) (13.66) (3.00) (6.11) (17.11)

as 4 6 11 7 1 5 34(11.76) (17.65) (32.35) (20.59) (2.94) (14.71) (0.35)

sq 0 9 5 7 0 2 23(0) (39.13) (21.74) (30.43) (0) (8.70) (0.24)

ud 0 0 1 2 0 1 4(0) (0) (25.00) (50.00) (0) (25.00) (0.04)

Misc. 0 1 1 1 0 0 3(0) (33.33) (33.33) (33.33) (0) (0) (0.03)

Total 783 3995 1936 2050 556 435 9755(8.02) (40.95) (19.84) (20.01) (5.70) (4.46)

(%)

Table 11-4.3. Histologic cell types and microscopic lymph node metastasis (13th edition),single cancer lesion

Cell type LN metastasis

Unknown NO N1 N2 N3 M Total

No report 89 53 21 10 12 2 187(47.59) (28.34) (11.23) (5.35) (6.42) (1.07) (1.91 )

pap 127 418 339 304 140 14 1342(9.46) (31.15) (25.26) (22.65) (10.43) (1.04) (13.76)

tub1 15 673 124 109 41 8 970(1.55) (69.38) (12.78) (11.24) (4.23) (0.82) (9.94)

tub2 192 788 413 446 168 6 2013(9.54) (39.15) (20.52) (22.16) (8.35) (0.30) (20.63)

por 270 976 731 876 312 48 3213(8.40) (30.38) (22.75) (27.26) (9.71) (1.49) (32.94)

muc 35 57 91 84 26 4 297(11.78) (19.19) (30.64) (28.28) (8.75) (1.35) (3.04)

sig 51 1014 225 224 112 43 1669(3.06) (60.75) (13.48) (13.42) (6.71) (2.58) (17.11)

as 4 6 11 6 6 1 34(11.76) (17.65) (32.35) (17.65) (17.65) (2.94) (0.35)

sq 0 9 5 5 4 0 23(0) (39.13) (21.74) (21.74) (17.39) (0) (0.24)

ud 0 0 1 1 1 1 4(0) (0) (25.00) (25.00) (25.00) (25.00) (0.04)

Misc. 0 1 1 1 0 0 3(0) (33.33) (33.33) (33.33) (0) (0) (0.03)

Total 783 3995 1962 2066 822 127 9755(8.02) (4095) (20.11 ) (21.18) (8.43) (1.30)

(%)


Table 11-4.4. Histologic cell types and wall invasion, single cancer lesion

Cell type Wall invasion

Unknown M SM MP SS SE SI-SEI Total

No report 162 5 1 1 7 10 1 187(86.63) (2.67) (0.53) (0.53) (3.74) (5.35) (0.53) (191)

pap 2 116 145 155 468 411 45 1342(0.15) (8.64) (10.80) (11.55) (34.87) (30.63) (3.35) (13.76)

tub1 0 370 237 110 135 98 20 970(0) (38.14) (24.43) (11.34) (13.92) (10.10) (2.06) (9.94)

tub2 0 294 277 226 590 567 59 2013(0) (14.61) (13.76) (11.23) (29.31) (28.17) (2.93) (20.63)

par 0 239 331 283 661 1592 107 3213(0) (7.44) (10.30) (8.81) (20.57) (49.55) (3.33) (32.94)

mue 1 7 16 26 57 179 11 297(0.34) (2.36) (5.39) (8.75) (19.19) (60.27) (3.70) (3.04)

sig 1 588 297 112 125 496 50 1669(0.06) (35.23) (17.80) (6.71) (7.49) (29.72) (3.00) (17.11)

as 0 0 1 1 10 18 4 34(0) (0) (2.94) (2.94) (29.41) (52.94) (11.76) (0.35)

sq 1 0 0 0 12 8 2 23(4.35) (0) (0) (0) (52.17) (34.78) (8.70) (0.24)

ud 0 0 1 1 1 1 0 4(0) (0) (25.00) (25.00) (25.00) (25.00) (0) (0.04)

Misc. 0 0 0 1 1 1 0 3(0) (0) (0) (33.33) (33.33) (33.33) (0) (0.03)

Total 167 1619 1306 916 2067 3381 299 9755(1.71) (16.60) (13.39) (9.39) (21.19) (34.66) (3.07)

(%)

Table 11-4.5. Histologic cell types and peritoneal dissemination, single cancer lesion

Cell type Dissemination

Unknown PO PI P2 P3 Total

No report 0 170 7 6 4 187(0) (90.91 ) (3.74) (3.21) (2.14) (1.92)

pap 0 1240 27 54 21 1342(0) (92.40) (2.01) (4.02) (1.56) (13.76)

tub1 0 944 4 16 6 970(0) (97.32) (0.41) (1.65) (0.62) (9.94)

tub2 0 1859 33 96 25 2013(0) (92.35) (1.64) (4.77) (1.24) (20.64)

par 0 2703 148 258 104 3213(0) (84.13) (4.61) (8.03) (3.24) (32.94)

mue 0 247 20 22 8 297(0) (83.16) (6.73) (7.41) (2.69) (3.04)

sig 1 1501 49 74 44 1669(0.06) (89.93) (2.94) (4.43) (2.64) (17.11)

Misc. 0 60 0 4 0 64(0) (88.24) (0) (11.76) (0) (0.66)

Total 1 8724 288 530 212 9755(0.01 ) (89.43) (2.95) (5.43) (2.17)

(%)

Background Factor' Pathology 235

Table 11-4.6. Cell differentiation and peritoneal dissemination, single cancer lesion

Differentiation Dissemination


Unknown 0 170 7 6 4 187(0) (90.91) (3.74) (3.21 ) (2.14) (1.92)

Differentiated 0 4043 64 166 52 4325(0) (93.48) (1.48) (3.84) (1.20) (44.34)

Undifferentiated 1 4511 217 358 156 5243(0.02) (86.04) (4.14) (6.83) (2.98) (53.75)

Total 1 8724 288 530 212 9755(0.01) (89.43) (2.95) (5.43) (2.17)

(%)

Table 11-4.7. Cell type and peritoneal dissemination, by wall invasion (missing 167 data)

Cell type Peritoneal dissemination


Wall invasion: m-ss

No report 0 14 0 0 0 14(0) (100.00) (0.00) (0) (0) (0.24)

pap 0 866 5 12 1 884(0) (97.96) (0.57) (1.36) (0.11) (14.96)

tub1 0 849 1 1 1 852(0) (99.65) (0.12) (0.12) (0.12) (14.42)

tub2 0 1361 5 19 2 1387(0) (98.13) (0.36) (1.37) (0.14) (23.48)

por 0 1459 20 27 8 1514(0) (96.37) (1.32) (1.78) (0.53) (25.63)

mue 0 100 4 0 2 106(0) (94.34) (3.77) (0) (1.89) (1.79)

sig 1 1117 1 2 1 1122(0.09) (99.55) (0.09) (0.18) (0.09) (18.99)

Misc. 0 29 0 0 0 29(0) (100.00) (0) (0) (0) (0.49)

Total 1 5795 36 61 15 5908(0.02) (98.09) (0.61) (1.03) (0.25)

Wall invasion: se

No report 0 5 2 1 2 10(0) (50.00) (20.00) (10.00) (20.00) (0.30)

pap 0 337 18 38 18 411(0) (82.00) (4.38) (9.25) (4.38) (12.17)

tub1 0 81 3 11 3 98(0) (82.65) (3.06) (11.22) (3.06) (2.90)

tub2 0 449 26 72 20 567(0) (79.19) (4.59) (12.70) (3.53) (16.77)

por 0 1177 120 209 86 1592(0) (73.93) (7.54) (13.13) (5.40) (47.09)

mue 0 136 16 21 6 179(0) (75.98) (8.94) (11.73) (3.35) (5.29)

sig 0 359 37 63 37 496(0) (72.38) (7.46) (12.70) (7.46) (14.67)

Misc. 0 24 0 4 0 28(0) (77.78) (0) (22.22) (0) (0.83)

Total 0 2568 222 419 172 3381(0) (75.95) (6.57) (12.39) (5.09)


Table 11-4.8. (Continued)Cell type Peritoneal dissemination

Unknown PO P1 P2 P3 Total

Wall invasion: si-sei

No report 0 1 0 0 0 1(0) (100.00) (0) (0) (0) (0.33)

pap 0 35 4 4 2 45(0) (77.78) (8.89) (8.89) (4.44) (15.05)

tub1 0 14 0 4 2 20(0) (70.00) (0) (20.00) (10.00) (6.69)

tub2 0 49 2 5 3 59(0) (83.05) (3.39) (8.47) (5.08) (19.73)

por 0 67 8 22 10 107(0) (62.62) (7.48) (20.56) (9.35) (35.79)

mue 0 10 0 1 0 11(0) (90.91) (0) (9.09) (0) (3.68)

sig 0 24 11 9 6 50(0) (48.00) (22.00) (18.00) (12.00) (16.72)

Misc. 0 6 0 0 0 6(0) (100.00) (0) (0) (0) (2.01)

Total 0 206 25 45 23 299(0.00) (68.90) (8.36) (15.05) (7.69)

&Total 1 8569 283 525 210 9588(0.01) (89.37) (2.95) (5.48) (2.19)

('Yo)

Table 11-4.9. Histologic cell types and liver metastasis, single cancer lesion

Cell type Liver metastasis

Unknown HO H1 H2 H3 Total

No report 1 184 2 0 0 187(0.53) (98.40) (1.07) (0) (0) (1.92)

pap 0 1205 37 62 38 1342(0) (89.79) (2.76) (4.62) (2.83) (13.76)

tub1 2 941 7 8 12 970(0.21) (97.01) (0.72) (0.82) (1.24) (9.94)

tub2 1 1899 33 45 35 2013(0.05) (94.34) (1.64) (2.24) (1.74) (20.64)

por 0 3151 24 20 18 3213(0) (98.07) (0.75) (0.62) (0.56) (32.94)

mue 0 294 2 0 1 297(0) (98.99) (0.67) (0) (0.34) (3.04)

sig 4 1661 3 1 0 1669(0.24) (99.52) (0.18) (0.06) (0) (17.12)

Misc. 0 56 2 3 3 64(0) (91.18) (2.94) (2.94) (2.94) (0.66)

Total 8 9391 110 139 107 9755(0.08) (96.27) (1.13) (1.42) (1.97)

('Yo)

Background Factor· Pathology 237

Table 11-4.10. Cell differentiation and liver metastasis, single cancer lesion

Differentiation Liver metastasis

Unknown HO HI H2 H3 Total

No report 1 184 2 0 0 187(0.53) (98.40) (1.07) (0) (0) (1.92)

Differentiated 3 4045 77 115 85 4325(0.07) (93.53) (1.78) (2.66) (1.97) (44.34)

Undifferentiated 4 5162 31 24 22 5243(0.08) (98.46) (0.59) (0.46) (0.42) (53.75)

Total 8 9391 110 139 107 9755(0.08) (96.27) (1.13) (1.42) (1.10)

(%)

Table 11-4.11. Histogic type and liver metastasis, by wall invasion

Cell type Liver metastasis

Unkown HO HI H2 H3 Total

Wall invasion: m-ss

No report 0 14 0 0 0 14(0) (100.00) (0) (0) (0) (0.24)

pap 0 824 18 26 16 884(0) (93.21) (2.04) (2.94) (1.81) (14.96)

tub1 2 840 2 4 4 852(0.23) (98.59) (0.23) (0.47) (0.47) (14.42)

tub2 1 1336 14 20 16 1387(0.07) (96.32) (1.01 ) (1.44) (1.15) (23.48)

par 0 1496 6 6 6 1514(0) (98.81) (0.40) (0.40) (0.40) (25.63)

mue 0 105 0 0 1 106(0) (99.06) (0) (0) (0.94) (1.79)

sig 4 1118 0 0 0 1122(0.36) (99.64) (0) (0) (0) (18.99)

Misc. 0 28 1 0 0 29(0) (100.00) (0) (0) (0) (0.49)

Total 7 5760 41 56 44 5908(0.12) (97.94) (0.69) (0.95) (0.74)

Wall invasion: se

No report 0 10 0 0 0 10(0) (100.00) (0) (0) (0) (0.30)

pap 0 342 14 33 22 411(0) (83.21) (3.41) (8.03) (5.35) (12.16)

tub1 0 86 3 3 6 98(0) (87.76) (3.06) (3.06) (6.12) (2.90)

tub2 0 508 17 23 19 567(0) (89.59) (3.00) (4.06) (3.35) (16.77)

par 0 1551 16 13 12 1592(0) (97.42) (1.01) (0.82) (0.75) (47.09)

mue 0 177 2 0 0 179(0) (98.88) (1.12) (0) (0) (5.29)

sig 0 492 3 1 0 496(0) (99.19) (0.60) (0.20) (0) (14.67)

Misc. 0 23 1 2 2 28(0) (83.33) (5.56) (5.56) (5.56) (0.83)

Total 0 3189 56 75 61 3381(0) (94.32) (1.66) (2.22) (1.80)


Table 11-4.11. (Continued)Cell type Liver metastasis

Unkown HO HI H2 H3 Total

Wall invasion: si-sei

No report 0 1 0 0 0 1(0) (100.00) (0) (0) (0) (0.33)

pap 0 38 4 3 0 45(0) (84.44) (8.89) (6.67) (0) (15.05)

tubl 0 15 2 1 2 20(0) (75.00) (10.00) (5.00) (10.00) (6.69)

tub2 0 55 2 2 0 59(0) (93.22) (3.39) (3.39) (0) (19.73)

por 0 104 2 1 0 107(0) (97.20) (1.87) (0.93) (0) (35.79)

muc 0 11 0 0 0 11(0) (100.00) (0) (0) (0) (3.68)

sit 0 50 0 0 0 50(0) (100.00) (0) (0) (0) (16.72)

Misc. 0 6 0 0 0 6(0) (100.00) (0) (0) (0) (2.01)

Total 0 280 10 7 2 299(0) (93.65) (3.34) (2.34) (0.67)

7 9229 107 138 107 9588(0.07) (96.26) (1.16) (1.44) (1.12)

(%)

Table 11-4.12. Histologic classification (JGCA), single cancer lesion

Cell type 1946-1949 1950-1959 1960-1969 1970-1979 1980-1989 1990- Total

No report 0 14 2 4 11 156 187(0) (0.88) (0.11) (0.20) (0.46) (9.10) (1.92)

pap 16 293 397 366 270 0 1342(8.12) (18.32) (20.89) (18.51) (11.41) (0) (13.76)

tub1 0 56 20 10 458 426 970(0) (3.50) (1.05) (0.51) (19.35) (24.84) (9.94)

tub2 81 570 470 390 249 253 2013(41.12) (35.65) (24.74) (19.73) (10.52) (14.75) (20.64)

por 86 549 754 778 662 384 3213(43.65) (34.33) (39.68) (39.35) (27.97) (22.39) (32.94)

muc 12 51 78 51 70 35 297(6.09) (3.19) (4.11) (2.58) (2.96) (2.04) (3.04)

sig 2 54 165 357 638 453 1669(1.02) (3.38) (8.68) (18.06) (26.95) (26.41) (17.11)

as 0 6 5 16 6 1 34(0) (0.38) (0.26) (0.81) (0.25) (0.06) (0.35)

sq 0 5 9 5 2 2 23(0) (0.31) (0.47) (0.25) (0.08) (0.12) (0.24)

ud 0 1 0 0 1 2 4(0) (0.06) (0) (0) (0.04) (0.12) (0.04)

Misc. 0 0 0 0 0 3 3(0) (0) (0) (0) (0) (0.17) (0.03)

Total 197 1599 1900 1977 2367 1715 9755(2.01) (16.39) (19.48) (20.27) (24.26) (17.58)

(%)

Background Factor· Pathology 239

Table 11-4.13. Histologic classification (CIH), single cancer lesion

Cell type 1946-1949 1950-1959 1960-1969 1970-1979 1980-1989 1990- Total

pap 0 7 9 1 5 0 22(0) (0.44) (0.47) (0.05) (0.21) (0) (0.23)

paptub 16 295 399 369 528 175 1782(8.12) (18.45) (21.00) (18.66) (22.31 ) (10.20) (18.27)

tubmed 81 614 479 395 437 501 2507(41.12) (38.40) (25.21) (19.98) (18.46) (29.21) (25.70)

muconod 12 51 78 51 70 35 297(6.09) (3.19) (4.11 ) (2.58) (2.96) (2.04) (2.86)

acin 52 100 77 80 113 89 511(26.40) (6.25) (4.05) (4.05) (4.77) (5.19) (5.24)

mucocel 2 58 165 356 638 463 1682(1.02) (3.63) (8.68) (18.01) (26.95) (27.00) (17.24)

tubscir 7 10 33 77 36 6 169(3.55) (0.63) (1.74) (3.89) (1.52) (0.35) (1.72)

scir 27 438 644 623 521 276 2529(13.71) (27.39) (33.89) (31.51) (22.01) (16.09) (25.92)

acanth 0 6 5 16 6 1 34(0) (0.38) (0.26) (0.81) (0.25) (0.06) (0.35)

sq 0 5 9 5 2 2 23(0) (0.31) (0.47) (0.25) (0.08) (0.12) (0.24)

Misc. 0 1 0 0 0 5 6(0) (0.06) (0) (0) (0) (0.29) (0.06)

No report 0 14 2 4 11 162 193(0) (0.88) (0.11) (0.20) (0.46) (9.45) (1.98)

Total 197 1599 1900 1977 2367 1715 9755(2.02) (16.39) (19.48) (20.27) (24.26) (17.58)

(%)

5. Treatment

Table 11-5.1. Surgery, all cases Table 11-5.3. Type of resection, all

Surgery Frequency % cases

No 237 1.9 Resection Frequency %

Yes 12182 98.1 No surgery 195

12419 Distal gast. 7277 59.5Prox.gas!. 498 4.1Total gast. 3312 27.1

Table 11-5.2. Surgical approach, all cases Segment 126 1.0Focal 33 0.3

Approach Frequency % No resection 902 7.4

No surgery 234 EMR 38 0.3Post-EMR g 38 0.3

Laparotomy 11599 95.2Oblique thoracoabdominal 253 2.1 12419

Mid thorcoabdominal 285 2.3 EMR, endoscopic mucosal resectionThoracodiaphragmatic 33 0.3 (included in No surgery in the previousSternoabdominal 2 0.0 table); gas!., gastrectomy.Laparodiaphragmatic 13 0.1

12419


Table 11-5.4. Method of reconstruction, all cases

Table 11-5.7. Left upper abdominalevisceration, all cases

Method Frequency % Surgery Frequency %

DIN: double tract after nishi.

Frequency %

Table II-5.S. Grade of lymph nodedissection, all cases

Unknown 1107

DO 830 7.301 3081 27.2D2 6681 59.1D3 647 5.704 73 0.6

12419

97.92.0

322

11850247

12419

NoYes

Unknown

36.026.98.79.4

13.70.70.10.10.10.81.40.41.7

1161

40493031

98010581540

771196

9516246

19412419

No reconstruction

Billroth 1Billroth 2InterpositionDouble tractPaiRouAlphaBetaPantalloonFigure-of-eightEsophagogastricDTNMisc.

Table II-5.5. Type of surgery for noresection, all cases

Frequency %

Resected

Simple lap.G-EJejunostomyBiliary bypassGastrostomyart. anusMisc.

11516

251441123

1578

2212419

27.848.813.60.16.30.92.4

Table 11-5.9. Macroscopic curability(11 th edition), all casesCurability Frequency %

Unknown 248

Abs. curative 7276 59.8ReI. curative 1623 13.3ReI. noncurative 784 6.4Abs. noncurative 2488 20.4

12419

G-E, gastroenterostomy; Art., artery. Abs., absolutely; ReI., relatively.

Table 11-5.6. Combined resection, allcases

Table 11-5.10. Microscopic curability (lIth

edition), all casesType Frequency % Curability Frequency %

NonePSPDColonLiverPancreasGallbladderKidneyApplebyEsophagusSpleenOvaryDiaphragmPortal veinAdrenalMisc.

85232253

196342

7539

36132

43537

302247

12419

68.618.1

1.62.80.60.32.9oo0.34.30.2oooo

Unknown, no responseAbs. curativeReI. curativeReI. noncurativeAbs. noncurative

Table 11-5.11. Operativeedition), all casesCurability

Unknown, no responseCurativeCurative?Not curative

8706473193610732067

12419

curability

Frequency

248543842442489

12419

7.052.115.68.6

16.6

%

2.043.834.220.0

PS, pancreatosplenectomy; PD, pancreatoduodenectomy.

Curability Frequency %

Table 11-5.12. Operative curability (13th

edition), all cases

Table 11-5.13. Chemotherapy, all

cases

Frequency %

Unknown 165

No 9302 75.9Yes 2952 24.1

12419

Frequency %

Route Frequency %

No chern, unkn 9578

Table 11-5.16. Route of drug administration, all cases

Background Factor' Treatment 241

Table 11-5.15. Chemotherapeutic drug admin-istered, all cases

Regimen Frequency %

No chemo.lunknown 9555

MMC 1365 47.75FU 191 6.7FT207 230 8.0ENOX 13 0.5AOM 7 0.2CQ 13 0.5N-UR 1 0.0MF 192 6.7MFC 326 11.4FAMT 18 0.6FA 19 0.7FAM 95 3.3PSK 15 0.5OK 13 0.5Nitrimin 10 0.3TESPA 4 0.1MFT 3 0.1COOP 90 3.1MF/C 74 2.6UFT 74 2.6EP 10 0.3EAP 3 0.1MXF 7 0.2UFTM 24 0.8MTX 12 0.4FL 8 0.3FLEP 39 1.4Furutulon 8 0.3

12419

2.039.838.120.0

3.32.6

83.80.09.10.01.1

9635

9373

23321

2521

32

12419

of chemotherapy

248494847342489

12419

Preop.Intraop.Postop.Pre/intraop.Intra/postop.Pre/intra/postop.Pre/postop.

UnknownCurativeCurative?Not curative

No chemo.lunknown

Time of administration

Table 11-5.14. Timing

administration, all cases

l.v.i.a.p.o.sups.c.Misc.

1908150329431

158

12419

67.25.3

11.615.20.50.3

i.v: intravenous.i.a: intra-arterial.p.o: oral intake (per os).sup: suppository.s.c.: subcutaneous.


Table 11-5.17. Irradiation, all casesIrradiation Frequency %

Table 11-5.20. General complications, all casesComplication Frequency %

Complications Frequency %

Table 11-5.18. Postoperative complications, all cases

Table 11-5.19. Surgical complications, all casesComplication Frequency %

No surgery, no description 967MOF, multiple organ failure; MRSA, methicillinresistant Staphylococcus aureus.

4.43.10.72.80.40.61.40.20.40.00.50.10.10.00.10.90.0

84.4

1877

46232379

2933863

14422442

546856

931

8899

12419

Frequency %

Unknow 12 0.1No 11963 96.:\Yes 444 3.6

12419

Table 11-5.21. Direct mortality, allcases

No surgery, no description

UnknownPulmonaryCardiacHepaticRenalCerebroneuroticGeneral weakMOFCholecystitisThrombosisAscitesParotitisThrombophlebitisCystitisHemophiliaMRSAPancreatitisNone

4.03.52.60.12.40.41.60.15.51.20.10.10.20.00.00.10.20.10.00.0

77.7

2.097.01.0

3.771.724.5

461397299

1627543

18410

627136

71627

54

1028721

889712419

46289103047

12419

24812047

124

12419

UnknownNoYes

UnknowNoYes

UnknownLeakBleedingNecrosisStenosisPeritonitisIleusAnesthesiaWound infectionPancreas fistulaPyothoraxProlapseBile fistulaFecal fistulaAU. loopReflux esophagitisWound dehiscenceChylofistulaPleural effusionPerforationNone

Aff., afferent loop syndrome.

Background Factor· Treatment 243

Table 11-5.22. Chronologie changes in surgical treatment, all surgical patients (n = 12182 frequency and percent)1946-1949 1950-1959 1960-1969 1970-1979 1980-1989 1990- Total

Approach

Unknow 0 0 0 0 0 1(0.01)

Laparotomy 261 2003 2291 2406 2694 1942 11597(100.00) (96.25) (95.42) (96.05) (93.35) (94.87) (95.20)

Oblique thoracoabdominal 0 11 0 2 151 88 252(0) (0.53) (0) (0.08) (5.23) (4.30) (2.07)

Mid thoracoabdominal 0 67 87 91 22 17 284(0) (3.22) (3.62) (3.63) (0.76) (0.83) (2.33)

Thoracodiaphragmatic 0 0 23 6 4 0 33(0) (0) (0.96) (0.24) (0.14) (0.00) (0.27)

Sternoabdominal 0 0 0 0 2 0 2(0) (0) (0) (0) (0.07) (0) (0.02)

Laparodiaphragmatic 0 0 0 0 13 0 13(0) (0) (0) (0) (0.45) (0) (0.11)

Total 261 2081 2401 2505 2886 2047 12182(2.14) (17.08) (19.71) (20.56) (23.69) (16.80)

Type of Resection

Distal g 171 1208 1487 1550 1731 1128 7275(65.52) (58.05) (61.93) (61.88) (59.98) (55.08) (59.72)

Prox. g 2 12 115 101 103 165 498(0.77) (0.58) (4.79) (4.03) (3.57) (8.06) (4.09)

Total g 31 474 560 710 961 576 3312(11.88) (22.78) (23.32) (28.34) (33.30) (28.13) (27.19)

Segmental res. 0 0 0 0 18 108 126(0) (0) (0) (0) (0.62) (5.27) (1.03)

Focal res. 0 0 0 2 6 23 31(0) (0) (0) (0.08) (0.21) (1.12) (0.25)

No res. 57 387 239 142 57 20 902(21.84) (18.60) (9.95) (5.67) (1.98) (0.98) (17.40)

PostEMR 0 0 0 0 10 28 38(0) (0) (0) (0) (0.35) (1.37) (0.31)

Total 261 2081 2401 2505 2886 2048 12182(2.14) (17.08) (19.71) (20.56) (23.69) (16.81)

G, gastrectomy; res., resection; postEMR, gastrectomy after endoscopic mucosal resection.Results in Tables 11-5.22 through 11-5.55 are frequencies and percents.(%)

Table 11-5.23. Chronological changes in the type of resection, single cancer lesionResection 1946-1949 1950-1959 1960-1969 1970-1979 1980-1989 1990- Total

Distal g 165 1138 1308 1287 1457 967 6322(2.61) (18.00) (20.69) (20.36) (23.05) (15.30) (64.81)

Prox. g 2 12 108 90 86 152 450(0.44) (2.67) (24.00) (20.00) (19.11) (33.78) (4.61 )

Total g 30 449 484 600 798 480 2841(1.06) (15.80) (17.04) (21.12) (28.09) (16.90) (29.12)

Segment 0 0 0 0 18 94 112(0) (0) .(0) (0) (16.07) (83.93) (1.15)

PostEMR g 0 0 0 0 8 22 30(0) (0) (0) (0) (26.67) (73.33) (0.31 )

Total 197 1599 1900 1977 2367 1715 9755(20.19) (16.39) (19.48) (20.27) (24.26) (17.58)

(%)


Table 11-5.24. Type of resection according to the tumor type, single cancer lesion

Resection Type 0 Type 1 Type 2 Type 3 Type 4 Type 5 Total

Distal g 2445 85 1222 1786 398 386 6322(38.67) (1.34) (19.33) (28.25) (6.30) (6.11) (64.81)

Prox.g 190 14 106 102 12 26 450(42.22) (3.11) (23.56) (22.67) (2.67) (5.78) (46.13)

Total g 277 49 430 979 889 217 2841(9.75) (1.72) (15.14) (34.46) (31.29) (7.64) (29.12)

Segment 109 0 0 1 0 2 112(97.32) (0) (0) (0.89) (0) (1.79) (1.15)

PostEMR g 30 0 0 0 0 0 30(100.00) (0) (0) (0) (0) (0) (0.31)

Total 3051 148 1758 2868 1299 631 9755(31.38) (15.18) (18.02) (29.40) (13.32) (6.47)

(%)

Table 11-5.25. Type of resection according to the tumor type, single cancer lesion

Resection Superficial Localized Intermediate Infiltrating Semiearly Total

Distal g 2411 1323 570 1754 264 6322(38.14) (20.93) (9.02) (27.74) (4.18) (64.81)

Prox. g 188 121 49 76 16 450(41.78) (26.89) (10.89) (16.89) (3.56) (4.61)

Total g 269 496 305 1656 115 2841(9.47) (17.46) (10.74) (58.29) (4.05) (29.12)

Segment 109 0 1 0 2 112(97.32) (0) (0.89) (0) (1.79) (1.15)

PostEMR g 30 0 0 0 0 30(100.00) (0) (0) (0) (0) (0.31)

Total 3007 1940 925 3486 397 9755(30.82) (19.89) (9.48) (35.74) (4.07)

(%)

Table 11-5.26. Type of resection and curability, single cancer lesion

Resection Unknown Curative Curative? Not curative Total

Distal g 0 3272 2200 850 6322(0) (51.76) (34.80) (13.45) (64.81)

Prox. g 0 233 166 51 450(0) (51.78) (36.89) (11.33) (4.61)

Total g 1 586 1675 579 2841(0.04) (20.63) (58.96) (20.38) (29.12)

Segment 0 12 99 1 112(0) (10.71) (88.39) (0.89) (1.15)

PostEMR g 0 18 12 0 30(0) (60.00) (40.00) (0) (0.31)

Total 1 4121 4152 1481 9755(0.01) (42.25) (42.56) (15.18)

(%)


Table II-S.27. Type of resection according to the tumor location, single cancer lesionResection Cardia Upper Middle Lower Whole Total

Distal g 0 131 2563 3318 310 6322(0) (2.07) (40.54) (52.48) (4.90) (64.81)

Prox. g 187 236 22 0 5 450(41.56) (52.44) (4.89) (0) (1.11) (4.61)

Total g 538 601 722 200 780 2841(18.94) (21.15) (25.41) (7.04) (27.46) (29.12)

Segment 0 8 99 5 0 112(0) (7.14) (88.39) (4.46) (0) (1.15)

PostEMR g 0 1 14 15 0 30(0) (3.33) (46.67) (50.00) (0) (0.31)

Total 725 977 3420 3538 1095 9755(7.43) (10.02) (35.06) (36.27) (11.23)

(%)

Table II-S.28. Relationship between the type of resection and location (missing 167 data)Resection Cardia Upper Middle Lower Whole Total

T Category: M

Distal g 0 43 831 441 14 1329(0) (3.24) (62.53) (33.18) (1.05) (82.09)

Prox.g 6 65 11 0 0 82(7.32) (79.27) (13.41 ) (0) (0) (5.06)

Total g 0 53 39 3 15 110(0) (48.18) (35.45) (2.73) (13.64) (6.79)

Segment 0 3 75 5 0 83(0) (3.61) (90.36) (6.02) (0) (5.13)

PostEMR g 0 1 10 4 0 15(0) (6.67) (66.67) (26.67) (0) (0.93)

Total 6 165 966 453 29 1619(0.37) (10.19) (59.67) (27.98) (17.91)

T Category: SM

Distal g 0 44 579 391 25 1039(0) (4.23) (55.73) (37.63) (2.41) (79.56)

Prox. g 7 71 4 0 0 82(8.54) (86.59) (4.88) (0) (0) (6.28)

Total g 5 76 45 3 27 156(3.21) (48.72) (28.85) (1.92) (17.31) (11.94)

Segment 0 3 15 0 0 18(0) (16.67) (83.33) (0) (0) (1.38)

PostEMRg 0 0 2 9 0 11(0) (0) (18.18) (81.82) (0) (0.84)

Total 12 194 645 403 52 1306(0.92) (14.85) (49.39) (30.86) (3.98)

T Category: MP

Distal g 0 17 284 415 10 726(0) (2.34) (39.12) (57.16) (1.38) (79.26)

Prox. g 11 30 1 0 0 42(26.19) (71.43) (2.38) (0) (0) (4.59)

Total g 15 59 46 10 14 144(10.42) (40.97) (31.94) (6.94) (9.72) (15.72)

Segment 0 1 3 0 0 4(0) (25.00) (75.00) (0) (0) (0.44)

Total 26 107 334 425 24 916(2.84) (11.68) (36.46) (46.40) (2.62)

(%)


Table 11-5.28. (Continued)Resection Cardia Upper Middle Lower Whole Total

T Category: SS

Distal g 0 13 366 927 62 1368(0) (0.95) (26.75) (67.76) (4.53) (66.18)

Prox. g 65 32 2 0 0 99(65.66) (32.32) (2.02) (0) (0) (4.79)

Total g 138 140 185 45 90 598(23.08) (23.41) (30.94) (7.53) (15.05) (28.93)

Segment 0 0 2 0 0 2(0) (0) (100.00) (0) (0) (0.10)

Total 203 185 555 972 152 2067(9.82) (8.95) (26.85) (47.02) (7.35)

T Category (11 th edition): SE

Distal g 0 12 433 1035 187 1667(0) (0.72) (25.97) (62.09) (11.22) (49.30)

Prox. g 86 26 3 0 3 118(72.88) (22.03) (2.54) (0) (2.54) (3.49)

Total g 304 239 362 127 564 1596(19.05) (14.97) (22.68) (7.96) (35.34) (47.20)

Total 390 277 798 1162 754 3381(11.54) (8.19) (23.60) (34.37) (22.30)

T Category: SI-SEI

Distal g 0 0 13 61 11 85(0) (0) (15.29) (71.76) (12.94) (28.42)

Prox. g 8 3 0 0 2 13(61.54) (23.08) (0) (0) (15.38) (4.35)

Total g 66 22 37 10 66 201(32.84) (10.95) (18.41) (4.98) (32.84) (67.22)

Total 74 25 50 71 79 299(24.75) (8.36) (16.72) (23.75) (26.42)

(%)

Table 11-5.29. Type of resection according to tumor size, single Table 11-5.30. Curability and combined resec-cancer lesion tion, single cancer lesionResection Tumor size Curability Combined resection

Large Medium Small Total No Yes Total

Distal g 1166 2948 2208 6322 Unknown 0 1 1(18.44) (46.63) (34.93) (64.81) (0) (100.00) (0.01)

Prox.g 75 183 192 450 Curative 3368 753 4121(16.67) (40.67) (42.67) (4.61) (81.73) (18.27) (42.25)

Total g 1649 989 203 2841 Curative? 2129 2023 4152(58.04) (34.81) (7.15) (29.12) (51.28) (48.72) (42.56)

Segment 0 5 107 112 Not curative 895 586 1481(0) (4.46) (95.54) (1.15) (60.43) (39.57) (15.18)

PostEMR g 0 0 30 30 Total 6392 3363 9755(0) (0) (100.00) (0.31) (65.53) (33.71 )

Total 2890 4125 2740 9755(%)(29.63) (42.29) (28.09)

(%)


Table 11-5.31. Type of reconstruction after gastrectomy, all surgical casesReconstruction 1946-1949 1950-1959 1960-1969 1970-1979 1980-1989 1990- Total

No resection 57 388 241 143 59 37 925(7.59)

Billroth 1 91 182 488 1218 1206 864 4049(44.61) (10.75) (22.59) (51.57) (42.66) (42.96) (33.24)

Billroth 2 79 1018 922 302 490 220 3031(38.73) (60.13) (42.69) (12.79) (17.33) (10.94) (24.88)

Interposition 1 82 119 80 454 244 980(0.49) (4.84) (5.51) (3.39) (16.06) (12.13) (8.04)

Double tract 0 14 350 393 182 119 1058(0) (0.83) (16.20) (16.64) (6.44) (5.92) (8.68)

Pai 18 327 180 278 403 334 1540(8.82) (19.31) (8.33) (11.77) (14.26) (16.61) (12.64)

Rou 2 58 2 11 4 0 77(0.98) (3.43) (0.09) (0.47) (0.14) (0) (0.63)

Alpha 0 0 1 1 2 6 10(0) (0) (0.05) (0.04) (0.07) (0.30) (0.08)

Beta 0 0 2 6 1 0 9(0) (0) (0.09) (0.25) (0.04) (0) (0.07)

Pantalloon 0 0 0 4 2 0 6(0) (0) (0) (0.17) (0.07) (0) (0.05)

Figure-of-8 0 1 27 38 23 6 95(0) (0.06) (1.25) (1.61) (0.81) (0.30) (0.78)

Esophagogastric 2 4 66 31 18 41 162(0.98) (0.24) (3.06) (1.31) (0.64) (2.04) (1.33)

Miscellaneous 11 7 3 0 25 147 193(5.39) (0.41) (0.14) (0) (0.88) (7.31) (1.58)

DTN 0 0 0 0 16 30 46(0) (0) (0) (0) (0.57) (1.49) (0.38)

Total 204 1693 2160 2362 2827 2011 12182(1.67) (13.90) (17.73) (19.39) (23.21) (16.51)

(%)

Table 11-5.32. Type of surgery for not resected cases, all surgical casesSurgery 1946-1949 1950-1959 1960-1969 1970-1979 1980-1989 1990- Total

Resected or 204 1695 2162 2361 2829 2028 11279unknown (92.58)

Simple laparotomy 9 138 42 36 23 3 251(15.79) (35.75) (17.57) (25.00) (40.35) (15.00) (2.06)

Gastroenterostomy 40 185 111 65 31 9 441(70.18) (47.93) (46.44) (45.14) (54.39) (45.00) (3.62)

Jejunostomy 3 30 57 30 1 2 123(5.26) (7.77) (23.85) (20.83) (1.75) (10.00) (1.01 )

Biliary bypass 0 0 1 0 0 0 1(0) (0) (0.42) (0) (0) (0) (0.01)

Gastrostomy 4 26 18 7 1 1 57(7.02) (6.74) (7.53) (4.86) (1.75) (5.00) (0.417)

Colostomy 1 0 2 2 1 2 8(1.75) (0) (0.84) (1.39) (1.75) (10.00) (0.07)

Miscellaneous 0 7 8 4 0 3 22(0) (1.81) (3.35) (2.78) (0) (15.00) (0.18)

Total 261 2081 2401 2505 2886 2048 12182(2.14) (17.08) (19.71) (20.56) (23.69) (16.81)

(%)


Table 11-5.33. Extent of lymph node dissection, all surgical cases

Dissection 1946-1949 1950-1959 1960-1969 1970-1979 1980-1989 1990- Total

No description/unknown 57 385 231 129 48 24 874(7.17)

DO 12 134 162 146 105 270 829(5.88) (7.90) (7.47) (6.14) (3.70) (13.34) (6.81)

01 87 473 757 846 643 274 3080(42.65) (27.89) (34.88) (35.61) (22.66) (13.54) (25.28)

02 105 1079 1201 1288 1771 1235 6679(51.47) (63.62) (55.35) (54.21) (62.40) (61.02) (54.83)

03 0 10 49 96 315 177 647(0) (0.59) (2.26) (4.04) (11.1 0) (8.75) (5.31)

04 0 0 1 0 4 68 73(0) (0) (0.05) (0) (0.14) (3.36) (0.60)

Total 261 2081 2401 2505 2886 2048 12182(2.14) (17.08) (19.71) (20.56) (23.69) (16.81)

(%)

Table 11-5.34. Left upper abdominal evisceration, all surgical cases

Evisceration 1946-1949 1950-1959 1960-1969 1970-1979 1980-1989 1990- Total

Unknown 0 77 0 0 3 16 96(0.79)

No 260 1996 2397 2502 2733 1951 11839(99.62) (99.60) (99.83) (99.88) (94.80) (95.92) (97.18)

Yes 1 8 4 3 150 81 247(0.38) (0.40) (0.17) (0.12) (5.20) (3.98) (2.02)

Total 261 2081 2401 2505 2886 2050 12182(2.14) (17.08) (19.71 ) (20.50) (23.69) (16.83)

(%)

Table 11-5.35. Curability (12th edition), all surgical cases

Curability 1946-1949 1950-1959 1960-1969 1970-1979 1980-1989 1990- Total

Unknown 0 0 0 0 0 16 16(0) (0) (0) (0) (0) (0.78) (0.13)

Curative 42 519 836 1204 1717 1119 5437(16.09) (24.94) (34.82) (48.06) (59.49) (54.64) (44.63)

Curative? 101 830 937 819 785 770 4242(38.70) (39.88) (39.03) (32.69) (27.20) (37.60) (34.82)

Not curative 118 732 628 482 384 143 2487(45.21) (35.18) (26.16) (19.24) (13.31 ) (6.98) (2Q.42)

Total 261 2081 2401 2505 2886 2048 12182(2.14) (17.08) (19.71) (20.56) (23.69) (16.81)

(%)


Table 11-5.36. Curability (13th edition), all surgical casesCurability 1946-1949 1950-1959 1960-1969 1970-1979 1980-1989 1990- Total

Unknown 0 0 0 0 0 16 16(0) (0) (0) (0) (0) (0.78) (0.13)

Curative 37 471 757 1056 1593 1033 4947(14.18) (22.63) (31.53) (42.16) (55.20) (50.44) (40.61 )

Curative? 106 878 1016 967 909 856 4732(40.61) (42.19) (42.32) (38.60) (31.50) (41.80) (38.84)

Not curative 118 732 628 482 384 143 2487(45.21) (35.18) (26.16) (19.24) (13.31) (6.98) (20.41)

Total 261 2081 2401 2505 2886 2048 12182(2.14) (17.08) (19.71) (20.56) (23.69) (16.81 )

(%)

Table 11-5.37. Lymph node dissection and curability (12th edition), single cancer lesionDissection Unknown Curative Curative? Not curative Total

Unknown 0 0 7 0 7(0.07)

DO 0 0 264 404 668(0) (0) (39.52) (60.48) (6.85)

Dl 1 1264 709 655 2629(0.04) (48.08) (26.97) (24.91) (26.95)

D2 0 3162 2297 348 5807(0) (54.45) (39.56) (5.99) (59.52)

D3 0 115 397 69 581(0) (19.79) (68.33) (11.88) (5.96)

D4 0 5 53 5 63(0) (7.94) (84.13) (7.94) (0.65)

Total 1 4546 3727 1481 9755(0.01) (46.60) (38.21 ) (15.18)

(%)

Table 11-5.38. Lymph node dissection and curability (13th edition), single cancer lesionDissection Unknown Curative Curative? Not curative Total

Unknown 0 0 7 0 7(0.07)

DO 0 0 264 404 668(0) (0) (39.52) (60.48) (6.85)

Dl 1 1181 792 655 2629(0.04) (44.92) (30.13) (24.91 ) (26.95)

D2 0 2849 2610 348 5807(0) (49.06) (44.95) (5.99) (59.52)

D3 0 87 425 69 581(0) (14.97) (73.15) (11.88) (5.96)

D4 0 4 54 5 63(0) (6.35) (85.71) (7.94) (0.65)

Total 1 4121 4152 1481 9755(0.01 ) (42.25) (42.56) (15.18)

(%)


Table 11-5.39. Lymph node dissection and clinical stages (12th edition), single cancer lesion

Dissection Unknown Ia Ib II IlIa I1Ib IVa IVb Total

Unknown 0 4 0 0 0 0 2 7(0.07)

DO 12 235 16 3 11 15 25 351 668(1.80) (35.18) (2.40) (0.45) (1.65) (2.25) (3.74) (52.54) (6.85)

D1 0 1018 387 244 185 108 110 577 2629(0) (38.72) (14.72) (9.28) (7.04) (4.11 ) (4.18) (21.95) (26.95)

D2 6 1582 1070 953 842 523 343 488 5807(0.10) (27.24) (18.43) (16.41) (14.50) (9.01) (5.91) (8.40) (59.52)

D3 0 10 43 83 126 115 65 139 581(0) (1.72) (7.40) (14.29) (21.69) (19.79) (11.19) (23.92) (5.96)

D4 0 0 0 3 14 11 8 27 63(0) (0) (0) (4.76) (22.22) (17.46) (12.70) (42.86) (0.65)

Total 18 2849 1517 1286 1178 772 551 1584 9755(0.18) (29.21) (15.55) (13.18) (12.08) (7.91) (5.65) (16.24)

(%)

Table 11-5.40. Lymph node dissection and clinical stages (13th edition), single cancer lesion

Dissection Unknown Ia Ib II IlIa I1Ib IV Total

Unknown 4 0 0 0 7(0.07)

DO 16 235 16 3 11 15 372 668(2.40) (35.18) (2.40) (0.45) (1.65) (2.25) (55.69) (6.85)

01 22 1018 386 235 181 89 698 2629(0.84) (38.72) (14.68) (8.94) (6.88) (3.39) (26.55) (26.95)

D2 73 1582 1067 924 832 442 887 5807(1.26) (27.24) (18.37) (15.91) (14.33) (7.61) (15.27) (59.52)

D3 7 10 43 81 127 96 217 581(1.20) (1.72) (7.40) (13.94) (21.86) (16.52) (37.35) (5.96)

D4 0 0 0 3 14 11 35 63(0) (0) (0) (4.76) (22.22) (17.46) (55.56) (0.65)

Total 119 2849 1513 1246 1165 653 2210 9755(1.22) (29.21) (15.51) (12.77) (11.94) (6.69) (22.66)

(%)

Table 11-5.41. Postoperative complications, all surgical cases

Complications 1946-1949 1950-1959 1960-1969 1970-1979 1980-1989 1990- Total

Unknown 0 6 0 0 3 237 246(0) (0.29) (0) (0) (0.10) (11.57) (2.02)

No 151 1528 1740 1879 2105 1489 8892(57.85) (73.43) (72.47) (75.01) (72.94) (72.71 ) (72.99)

Yes 110 547 661 626 778 322 3044(42.15) (26.29) (27.53) (24.99) (26.96) (15.72) (24.99)

Total 261 2081 2401 2505 2886 2048 12182(2.14) (17.08) (19.71) (20.56) (23.69) (16.81)

(%)


Table 11-5.42. Type of resection and direct mortality (death Table 11-5.43. Type of resection and complications, single

within 1 month), single cancer lesion cancer lesion

Resection Direct mortality Resection Complications

Unknown No Yes Total Unknown No Yes Total

Distal g 3 6170 149 6322 Distal g 118 4973 1231 6322(0.05) (97.60) (2.36) . (64.81) (1.87) (78.66) (19.47) (64.81)

Prox. g 0 436 14 450 Prox. g 7 282 161 450(0) (96.89) (3.11) (4.62) (1.56) (62.67) (35.78) (4.62)

Total g 2 2760 79 2841 Total g 50 1728 1063 2841(0.07) (97.15) (2.78) (29.12) (1.76) (60.82) (37.42) (29.12)

Segment 0 106 6 112 Segment 13 89 10 112(0) (94.64) (5.36) (1.15) (11.61) (79.46) (8.93) (1.15)

PostEMR g 0 29 1 30 PostEMR g 3 24 3 30(0) (96.67) (3.33) (0.31) (10.00) (80.00) (10.00) (0.31)

Total 5 9501 249 9755 Total 191 7096 2468 9755(0.05) (97.40) (2.55) (1.96) (72.74) (25.30)

(%) (%)

Table 11-5.44. Combined resection and postoperative compli- Table 11-5.45. Combined resection and operative mortalitycations, single cancer lesion (within 1 month), single cancer lesion

Site Postoperative complications Resection Operative mortality

Unknown No Yes Total Unknown No Yes Total

None 127 5096 1171 6394 None 4 6251 139 6394

(1.99) (79.70) (18.31) (65.55) (0.06) (97.76) (2.17) (65.55)

PS 24 1094 880 1998 Ps or PS + ex 1 1942 55 1998

(1.20) (54.75) (44.04) (20.44) (0.05) (97.20) (2.75) (20.44)

PO 1 101 74 176 PD or PD + ex 0 163 13 176

(0.57) (57.39) (42.05) (1.80) (0) (92.61) (7.39) (1.80)

Colon 1 178 116 295 Colectomy or 0 275 20 295

(0.34) (60.34) (39.32) (3.02) col. + ex (0) (93.22) (6.78) (3.02)

Liver 0 41 23 64 Hepatectomy 0 61 3 64

(0) (64.06) (35.94) (0.66) +ex (0) (95.31) (4.69) (0.66)

Pancreas 1 22 11 34 Pancreas or 0 33 1 34

(2.94) (64.71) (32.35) (0.35) pane. + ex (0) (97.06) (2.94) (0.35)

Gallbladder 16 229 57 302 Cholecystectomy 0 296 6 302

(5.30) (75.83) (18.87) (3.10) (0) (98.01) (1.99) (3.10)

Kidney 0 1 0 1 Nephrectomy 0 1 0 1

(0) (100.00) (0) (0.01) (0) (100.00) (0) (0.01)

Appleby 0 1 1 2 Appleby 0 2 0 2

(0) (50.00) (50.00) (0.02) (0) (100.00) (0) (0.02)

Esophagus 0 13 11 24 Esophagectomy 0 23 1 24

(0) (54.17) (45.83) (0.25) (0) (95.83) (4.17) (0.25)

Spleen 21 288 120 429 Splenectomy 0 420 9 429

(4.90) (67.13) (27.97) (4.40) (0) (97.90) (2.10) (4.40)

Ovary 0 21 2 23 Oophorectomy 0 21 2 23

(0) (91.30) (8.70) (0.24) (0) (91.30) (8.70) (0.24)

Diaphragm 0 2 0 2 Miscellaneous 0 11 0 11

(0) (100.00) (0) (0.02) (0) (100.00) (0) (0.11 )

Portal vein 0 1 0 1 Total 5 9501 249 9755

(0) (100.00) (0) (0.01) (0.05) (97.40) (2.55)

Adrenal 0 2 2 4 (%)(0) (50.00) (50.00) (0.04)

Miscellaneous 0 6 0 6(0) (100.00) (0) (0.06)

Total 191 7096 2468 9755(1.96) (72.74) (25.30)

(%)


Table 11-5.46. Postoperative surgical complications, all surgical cases

Complication 1946-1949 1950-1959 1960-1969 1970-1979 1980-1989 1990- Total

Unknown 57 202 219 159 210 362 1209(21.84) (9.71) (9.12) (6.35) (7.28) (17.68) (9.92)

Leakage 15 53 49 79 144 57 397(5.75) (2.55) (2.04) (3.15) (4.99) (2.78) (3.26)

Bleeding 7 59 93 55 72 13 299(2.68) (2.84) (3.87) (2.20) (2.49) (0.63) (2.45)

Necrosis 0 2 7 1 6 0 16(0) (0.10) (0.29) (0.04) (0.21) (0) (0.13)

Stenosis 7 40 57 76 69 26 275(2.68) (1.92) (2.37) (3.03) (2.39) (1.27) (2.26)

Peritonitis 5 11 7 5 12 3 43(1.92) (0.53) (0.29) (0.20) (0.42) (0.15) (0.35)

Ileus 8 30 57 36 43 10 184(3.07) (1.44) (2.37) (1.44) (1.49) (0.49) (1.51)

Anesthesia 0 0 4 2 4 0 10(0) (0) (0.17) (0.08) (0.14) (0) (0.08)

Wound infection 8 112 149 182 135 41 627(3.07) (5.38) (6.21 ) (7.27) (4.68) (2.00) (5.15)

Pancreas fistula 1 23 8 17 51 36 136(0.38) (1.11) (0.33) (0.68) (1.77) (1.76) (1.12)

Pyothorax 0 2 3 1 0 1 7(0) (0.10) (0.12) (0.04) (0) (0.05) (0.06)

Prolapse 1 4 2 3 5 1 16(0.38) (0.19) (0.08) (0.12) (0.17) (0.05) (0.13)

Bile fistula 1 12 2 1 7 4 27(0.38) (0.58) (0.08) (0.04) (0.24) (0.20) (0.22)

Fecal fistula 0 0 2 1 2 0 5(0) (0) (0.08) (0.04) (0.07) (0) (0.04)

Afferent loop 0 0 0 1 3 0 4(0) (0) (0) (0.04) (0.10) (0) (0.03)

Reflux esophagitis 0 0 1 3 6 0 10(0) (0) (0.04) (0.12) (0.21) (0) (0.08)

Wound dehiscence 0 4 1 6 12 5 28(0) (0.19) (0.04) (0.24) (0.42) (0.24) (0.23)

Chylofistula 0 0 0 2 5 0 7

(0) (0) (0) (0.08) (0.17) (0) (0.06)

Pleural effusion 0 0 0 0 0 2 2(0) (0) (0) (0) (0) (0.10) (0.02)

Perforation 0 0 0 0 1 0 1(0) (0) (0) (0) (0.03) (0) (0.01)

None 151 1527 1740 1875 2099 1487 8879(57.85) (73.38) (72.47) (74.85) (72.73) (72.61) (72.89)

Total 261 2081 2401 2505 2886 2048 12182

(2.14) (17.08) (19.71) (20.56) (23.69) (16.81)

(%)


Table 11-5.47. Systemic complications, all surgical casesComplication 1946-1949 1950-1959 1960-1969 1970-1979 1980-1989 1990- Total

No reports 41 321 374 438 518 185 1877(15.70) (15.42) (15.58) (17.49) (17.95) (9.03) (15.47)

Unknown 0 6 0 0 3 237 246(0) (0.34) (0) (0) (0.13) (12.72) (2.02)

Pulmonary 41 73 66 42 82 19 323(18.64) (4.15) (3.26) (2.03) (3.46) (1.02) (2.65)

Cardiac 3 15 21 12 20 7 78(1.36) (0.85) (1.04) (0.58) (0.84) (0.38) (0.64)

Hepatic 1 24 88 74 73 33 293(0.45) (1.36) (4.34) (3.58) (3.08) (1.77) (2.41)

Renal 3 11 6 1 12 5 38(1.36) (0.63) (0.30) (0.05) (0.51) (0.27) (0.31)

Cerebroneurologic 5 10 12 15 20 1 63(2.27) (0.57) (0.59) (0.73) (0.84) (0.05) (0.52)

General weakness 7 38 62 24 11 0 142(3.18) (2.16) (3.06) (Ll6) (0.46) (0) (Ll7)

MOF 2 6 6 4 2 2 22(0.91) (0.34) (0.30) (0.19) (0.08) (0.11) (0.18)

Cholecystitis 2 15 11 5 9 2 44(0.91) (0.85) (0.54) (0.24) (0.38) (0.11) (0.36)

Thrombosis 0 0 1 0 1 0 2(0) (0) (0.05) (0) (0.04) (0) (0.02)

Ascites 4 27 9 9 5 0 54(1.82) (1.53) (0.44) (0.44) (0.21) (0) (0.44)

Parotitis 0 3 2 1 0 0 6(0) (0.17) (0.10) (0.05) (0) (0) (0.05)

Thrombophlebitis 1 2 3 0 0 2 8(0.45) (0.11) (0.15) (0) (0) (0.11) (0.07)

Cystitis 0 0 2 0 1 2 5(0) (0) (0.10) (0) (0.04) (0.11) (0.04)

Bleeding tendency 0 2 1 2 1 0 6(0) (0.11) (0.05) (0.10) (0.04) (0) (0.05)

MRSA 0 0 0 1 26 66 93(0) (0) (0) (0.05) (LlO) (3.54) (0.76)

Pancreatitis 0 0 0 1 0 0 1(0) (0) (0) (0.05) (0) (0) (0.01)

None 151 1528 1737 1876 2102 1487 8881(68.64) (86.82) (85.69) (90.76) (88.77) (79.82) (72.90)

Total 261 2081 2401 2505 2886 2048 12182(2.14) (17.08) (19.71) (20.56) (23.69) (16.81)

(%)


Table 11-5.48. Reasons of palliative surgery, all surgical casesIndication 1946-1949 1950-1959 1960-1969 1970-1979 1980-1989 1990- Total

Curative Surgery 115 1099 1579 1882 2333 1787 8795

................ - .. - ................................................................. .. .. .............................. ... . .......................... .. .. .. .. .. ..... ........ ..... .................(72.20)

T4 43 141 98 73 38 8 401(29.45) (14.36) (11.92) (11.72) (6.87) (3.07) (3.29)

Lymph nodes 48 355 330 237 234 88 1292(32.88) (36.15) (40.15) (38.04) (42.31) (33.72) (10.61)

Dissemination 40 321 281 220 211 111 1184(27.40) (32.69) (34.18) (35.31) (38.16) (42.53) (9.72)

Liver 13 145 109 90 65 37 459(8.90) (14.77) (13.26) (14.45) (11.75) (14.18) (3.77)

Surgical margin 2 20 4 3 5 15 49(1.37) (2.04) (0.49) (0.48) (0.90) (5.75) (0.40)

Distant metastasis 0 0 0 0 0 2 2(0.00) (0.00) (0.00) (0.00) (0.00) (0.77) (0.02)

Total 261 2081 2401 2505 2886 2048 12182(2.14) (17.08) (19.71) (20.56) (23.69) (16.81)

(%)

Table 11-5.49. Chemotherapy combined with surgical treatment, all surgical casesTreatment 1946-1949 1950-1959 1960-1969 1970-1979 1980-1989 1990- Total

No 261 2065 1829 1639 1813 1659 9266(100.00) (99.23) (76.18) (65.43) (62.77) (80.92) (76.06)

Yes 0 16 572 866 1073 389 2916(0.00) (0.77) (23.82) (34.57) (37.23) (19.08) (23.94)

Total 261 2081 2401 2505 2886 2048 12182(2.14) (17.08) (19.71) (20.56) (23.69) (16.81)

(%)

Table 11-5.50. Chronological changes in 5-year survival according to the size of the tumor and the extent of lymph nodemetastasesCategory NO Nl N2 N3 N4 Total

1946-1997

Tumor size (mm)-4.9 95.5 (26) 95.5 (26)

5.0-9.9 92.5 (169) 100.0 (1) 100.0 (1) 92.6 (171)10.0-14.9 94.5 (397) 81.9 (18) 100.0 (2) 100.0 (1) 100.0 (1) 94.0 (419)15.0-19.9 95.2 (474) 74.6 (30) 57.1 (7) 100.0 (1) 0(1) 93.1 (513)20.0-29.9 96.5 (911) 89.1 (162) 56.1 (81) 13.6 (9) + (11) 91.3 (1174)30.0-39.9 90.9 (628) 67.0 (222) 44.0 (152) 14.6 (33) + (16) 75.2 (1051)40.0-79.9 82.8 (1074) 51.2 (1018) 29.5 (1123) 14.3 (307) 10.0 (183) 48.9 (3705)80.0- 64.9 (311) 36.9 (484) 18.7 (680) 10.4 (202) 6.9 (223) 28.9 (1900)

1946-1949

Tumor size (mm)-4.9

5.0-9.910.0-14.915.0-19.920.0-29.9 50.0 (2) 50.0 (2)30.0-39.9 100.0 (1) 0(3) 25.0 (4)40.0-79.9 70.8 (24) 44.0 (25) 27.0 (37) 0(8) 40.4 (94)80.0- 50.0 (6) 19.1 (21) 15.4 (13) 50.0 (2) 23.8 (42)


Table 11-5.50. (Continued)Category NO Nl N2 N3 N4 Total

1950-1959

Tumor size (mm)-4.9

5.0-9.9 100.0 (2) 100.0 (2)10.0-14.9 100.0 (4) 100.0 (2) 100.0 (6)15.0-19.9 100.0 (2) 100.0 (2)20.0-29.9 90.5 (21) 66.7 (6) 62.5 (8) 0(2) 75.7 (37)30.0-39.9 77.8 (36) 57.1 (28) 28.9 (22) 20.0 (5) 56.7 (91)40.0-79.9 70.3 (158) 45.5 (242) 25.9 (278) 8.8 (80) 0(20) 38.6 (778)80.0- 59.3 (81) 37.8 (111) 20.7 (145) 9.8 (41) 0(19) 31.2 (397)

1960-1969

Tumor size (mm)-4.9 1.0 (1) 100.0 (1)

5.0-9.9 100.0 (3) 100.0 (3)10.0-14.9 95.2 (21) 100.0 (1) 90.9 (22)15.0-19.9 90.9 (33) 50.0 (2) 0(1) 86.1 (36)20.0-29.9 93.8 (96) 75.0 (24) 44.4 (9) 0(5) 83.6 (134)30.0-39.9 85.6 (90) 56.0 (50) 34.6 (26) 8.3 (12) 0(5) 62.8 (183)40.0-79.9 79.6 (240) 47.8 (251) 25.5 (310) 15.1 (73) 6.3 (32) 44.5 (906)80.0- 59.5 (79) 37.4 (115) 13.7 (175) 10.2 (59) 9.7 (31) 26.8 (456)

1970-1979

Tumor size (mm)-4.9 100.0 (1) 100.0 (1)

5.0-9.9 93.1 (29) 93.1 (29)10.0-14.9 90.0 (50) 90.0 (50)15.0-19.9 96.1 (102) 75.0 (8) 0(2) 92.9 (112)20.0-29.9 97.1 (204) 96.0 (25) 52.9 (17) 0(1) 0(1) 93.2 (248)30.0-39.9 90.3 (155) 64.0 (50) 34.3 (35) 14.3 (7) 0(2) 74.3 (249)40.0-79.9 84.0 (281) 51.2 (211) 30.7 (218) 8.9 (56) 7.4 (27) 52.7 (793)80.0- 82.5 (63) 26.9 (108) 16.7 (156) 10.3 (29) 8.6 (35) 28.9 (391)

1980-1989

Tumor size (mm)-4.9 92.3 (13) 92.3 (13)

5.0-9.9 91.7 (85) 100.0 (1) 91.8 (86)10.0-14.9 94.6 (168) 80.0 (10) 100.0 (2) 100.0 (1) 93.9 (181)15.0-19.9 93.6 (187) 87.5 (8) 100.0 (3) 20.0 (5) 93.4 (198)20.0-29.9 96.8 (313) 92.7 (55) 60.7 (28) 33.3 (5) 0(3) 92.1 (404)30.0-39.9 93.4 (197) 75.0 (60) 58.3 (36) 17.7 (3) 0(4) 84.0 (300)40.0-79.9 88.8 (223) 56.0 (191) 36.4 (184) 17.7 (51) 6.5 (61) 54.2 (710)80.0- 56.9 (51) 46.2 (91) 20.7 (135) 10.0 (40) 7.6 (92) 26.9 (409)

1990-1997

Tumor size (mm)-4.9 92.3 (13) 100.0 (11)

5.0-9.9 91.7 (85) 100.0 (1) 94.3 (51)10.0-14.9 94.6 (168) 80.0 (10) 100.0 (2) 100.0 (1) 95.2 (160)15.0-19.9 93.5 (187) 87.5 (8) 100.0 (3) 94.8 (165)20.0-29.9 96.8 (313) 92.7 (55) 60.7 (28) 20.0 (5) 0(3) 95.6 (349)30.0-39.9 93.9 (197) 75.0 (60) 58.3 (36) 33.3 (3) 0(4) 86.1 (224)40.0-79.9 88.8 (223) 56.0 (191) 36.4 (184) 17.7 (51) 6.6 (61) 70.3 (424)80.0- 56.9 (51) 46.2 (91) 20.7 (135) 10.0 (40) 7.6 (92) 38.1 (202)


Table 11-5.51. Chronological changes in 5-year survival rates according to wall invasion and lymph node metastasis (12th

edition)

Wall invasion NO Nl N2 N3 N4 Total

1946-1997

t1 95.6 (2580) 87.3 (218) 72.8 (87) 41.7 (9) 42.8 (4) 94.0 (2898)t2 83.5 (973) 61.8 (877) 39.3 (701) 16.7 (182) 15.4 (94) 59.3 (2827)t3 61.0 (376) 36.1 (782) 19.8 (1153) 11.8 (305) 6.8 (272) 27.8 (2895)t4 28.6 (18) 15.4 (39) 8.8 (97) 2.4 (54) 5.1 (56) 8.5 (264)? 97.7 (47) 62.3 (12) 61.2 (9) 0(4) 22.0 (9) 76.1 (81)

Total 88.7 (3994) 53.0 (1935) 28.1 (2047) 13.1 (554) 8.5 (435) (8965) (+7)

1946-1949

tlt2 69.2 (26) 57.9 (19) 19.1 (21) 12.5 (8) 46.0 (74)t3 50.0 (6) 17.9 (28) 25.8 (31) 0(2) 23.9 (67)t4 0(1) 0(1)

Total 65.6 (32) 34.0 (47) 22.6 (53) 10.0 (10) 35.2 (142)

1950-1959

tl 89.8 (49) 80.0 (10) 66.7 (9) 0(2) 0(0) H2.9 (70)t2 72.6 (208) 51.4 (255) 33.6 (236) 13.4 (67) 0(16) 47.4 (282)t3 40.0 (45) 29.6 (108) 14.6 (192) 6.7 (45) 0(21) 19.7(411)t4 50.0 (2) 18.8 (16) 0(16) 0(14) 0(2) 8.0 (50)

Total 70.4 (304) 44.7 (389) 25.0 (453) 9.4 (128) 0(39) 39.1 (1313)

1960-1969

t1 94.4 (270) 77.8 (36) 71.4 (14) 50.0 (2) 0(1) 91.0 (323)t2 79.2 (216) 54.2 (229) 33.5 (200) 15.1 (53) 13.8 (29) 51.2 (727)t3 46.4 (69) 34.3 (166) 12.9 (286) 11.3 (80) 2.6 (38) 21.3 (639)t4 28.6 (7) 8.3 (12) 10.0 (20) 0(10) 0(5) 9.3 (54)? 100.0 (1) 100.0 (1)

Total 81.5 (563) 47.4 (443) 22.3 (520) 12.4 (145) 6.9 (73) 46.3 (1744)

1970-1979

t1 95.7 (557) 89.7 (39) 61.1 (18) 0(1) 94.2 (615)t2 89.7 (195) 67.2 (116) 46.6 (73) 5.9 (17) 20.0 (5) 71.2 (408)t3 67.2 (128) 34.8 (244) 20.7 (319) 11.3 (71) 7.4 (54) 30.5 (816)t4 33.3 (5) 33.3 (3) 11.8 (18) 0(5) 0(5) 12.5 (36)

Total 90.1 (885) 49.5 (402) 26.6 (428) 9.7 (93) 7.7 (65) 60.0 (1873)

1980-1989

t1 95.2 (930) 88.5 (78) 80.0 (25) 66.7 (3) 94.2 (1036)t2 90.9 (198) 75.9 (162) 52.0 (100) 25.0 (16) 11.5 (26) 72.1 (502)t3 69.6 (102) 40.7 (167) 27.3 (231) 13.4 (67) 6.7 (104) 32.5 (671)t4 0(4) 0(7) 9.4 (32) 7.7 (13) 0(26) 4.9 (82)? 100.0 (3) 50.0 (2) 0(1) 25.0 (4) 50.0 (10)

Total 92.1 (1237) 62.7 (416) 35.6 (388) 16.0 (100) 6.9 (160) 68.0 (2301)

1990-1997

tl 97.4 (774) 92.6 (55) 82.1 (21) 50.0 (2) 100.0 (2) 96.6 (854)t2 94.3 (130) 85.4 (96) 64.3 (71) 57.8 (21) 48.7 (18) 80.6 (336)t3 77.9 (26) 54.9 (76) 31.5 (94) 21.9 (40) 24.0 (55) 40.2 (291)t4 0(2) 100.0 (1) 18.9 (11) 0(12) 0(19) 17.4 (45)? 97.4 (41) 64.8 (10) 50.0 (8) 0(3) 25.0 (4) 79.8 (66)

Total 96.3 (973) 76.0 (238) 46.9 (205) 29.4 (78) 28.3 (98) 80.1 (1592)


Table 11-5.52. Chronological changes in 5-year survival according to the extent and numbersof lymph node metastasis (12th edition)

NO (n =0) N (n =1-6) N2 (n =7-15) N3 (n =16+)

1946-1997

NO 88.7 (3982) 88.7 (3982)N1 55.2 (1748) 32.5 (180) 28.6 (7) 53.0 (1935)N2 37.5 (1033) 19.5 (880) 11.7 (134) 28.1 (2047)N3 23.9 (139) 10.2 (319) 5.9 (96) 13.1 (554)N4 16.9 (55) 10.8 (166) 2.6 (214) 8.5 (435)

Total 88.7 (3982) 46.9 (2975) 18.2 (1545) 7.0 (451)

1946-1949

NO 64.5 (31) 64.5 (31)Nl 41.7 (36) 10.0 (10) 0(1) 34.0 (47)N2 25.0 (24) 19.2 (26) 33.3 (3) 22.6 (53)N3 100.0 (1) 12.5 (8) 0(1) 10.0 (10)N4

Total 64.5 (31) 34.4 (61) 15.9 (44) 20.0 (5)

1950-1959

NO 69.8 (298) 69.8 (298)Nl 46.2 (353) 31.4 (35) 0(1) 44.7 (398)N2 35.3 (231) 14.4 (208) 14.3 (14) 25.0 (453)N3 11.8 (34) 7.4 (81) 15.4 (13) 9.4 (128)N4 0(14) 0(23) 0(2) 0(39)

Total 69.8 (298) 39.3 (632) 13.5 (347) 13.3 (30)

1960-1969

NO 81.6 (560) 81.6 (560)N1 48.2 (413) 34.8 (29) 100.0 (1) 47.4 (443)N2 29.8 (285) 13.6 (220) 6.7 (15) 22.3 (520)N3 22.5 (40) 8.8 (91) 7.1 (14) 12.4 (145)N4 ILl (18) 7.5 (40) 0(15) 6.9 (73)

Total 81.6 (560) 39.0 (756) 13.4 (380) 6.7 (45)

1970-1979

NO 90.0 (885) 90.0 (885)Nl 52.2 (358) 28.6 (42) 0(2) 49.5 (402)N2 32.4 (225) 21.7 (180) 8.7 (23) 26.6 (428)N3 22.7 (22) 6.9 (58) 0(13) 9.7 (93)N4 23.1 (13) 3.3 (30) 4.6 (22) 7.7 (65)

Total 90.0 (885) 43.4 (618) 18.1 (310) 5.0 (60)

1980-1989

NO 92.1 (1235) 92.1 (1235)Nl 65.1 (372) 44.2 (43) 0(1) 62.7 (416)N2 50.0 (172) 27.5 (178) 7.9 (38) 35.6 (388)N3 30.8 (26) 14.6 (48) 3.9 (26) 16.0 (100)N4 50.0 (8) 9.8 (51) 2.0 (101) 6.9 (160)

Total 92.1 (1235) 58.8 (578) 25.0 (320) 3.6 (166)

1990-1997

NO 96.3 (973) 96.3 (973)N1 81.5 (216) 24.9 (21) 100.0 (1) 76.0 (238)N2 68.8 (96) 31.1 (68) 18.5 (41) 46.9 (205)N3 63.4 (16) 27.9 (33) 44.8 (29) 29.4 (78)N4 50.0 (2) 60.8 (22) 25.3 (74) 28.3 (98)

Total 96.3 (973) 76.9 (330) 33.2 (144) 14.2 (145)


Table 11-5.53. Effect of lymph node dissection: 5-year survival rate according to the extentof dissection and lymphatic spread

NO Nl N2 N3 N4 Total

Wall invasion M-SM

00 89.5 (234) 75.0 (4) * (2) 0(2) - (0) 88.1 (242)01 94.1 (1143) 78.8 (62) 66.8 (31) 0(1) * (2) 92.4 (1239)02 94.2 (1744) 88.7 (193) 65.8 (64) 40.0 (5) 0(1) 92.5 (2007)D3 83.5 (22) 83.3 (8) 75.0 (5) 40.0 (5) 0(2) 72.0 (42)04 * (1) * (1) * (2)

Total 93.9 (3147) 85.9 (267) 65.4 (103) 27.3 (13) * (6)

Wall invasion MP-SS

00 69.2 (15) 7.1 (14) 10.0 (10) 0(1) * (2) 26.3 (42)D1 81.2 (334) 55.9 (242) 33.6 (134) 12.9 (25) 0(12) 60.8 (747)D2 84.1 (772) 64.7 (678) 40.6 (569) 15.0 (133) 14.7 (55) 60.8 (2207)D3 86.9 (27) 72.8 (40) 50.2 (51) 17.7 (37) 19.5 (27) 50.1 (182)04 * (1) * (5) * (7) * (3) * (7) * (23)

Total 83.2 (1149) 62.0 (979) 39.5 (771) 15.9 (199) 15.0 (103)

Wall invasion SE

00 33.3 (3) 1.8 (57) * (23) 0(5) 0(9) 2.6 (97)01 56.5 (92) 25.0 (240) 10.1 (258) 2.9 (35) 9.2 (27) 21.7 (652)02 61.2 (298) 44.8 (481) 21.8 (853) 10.0 (239) 6.6 (152) 30.8 (2023)03 73.2 (29) 37.6 (67) 34.0 (122) 17.4 (58) 6.3 (89) 28.4 (365)04 * (1) * (7) * (7) * (4) * (19) * (38)

Total 60.8 (423) 35.9 (852) 20.2 (1263) 10.5 (341) 6.9 (297)

Wall invasion SI-SEI

00 0(4) 0(4) * (2) 0(1) * (11)D1 33.3 (3) 18.2 (11) 0(16) 0(4) 0(3) 8.1 (37)02 27.3 (14) 16.7 (24) 9.8 (76) 2.8 (41) * (38) 8.7 (193)D3 * (2) * (3) 12.5 (8) * (8) * (16) 4.2 (37)04 * (1) * (1) * (4) * (6)

Total 29.1 (19) 14.7 (42) 8.2 (105) 2.3 (56) * (62)

Table 11-5.54. Five-year survival rates according to the tumor size and lymph node metastasis, all casesTumor size (mm) NO Nl N2 N3 N4 Total

-4.9 95.5 (26) 95.5 (26)5.0-9.9 93.2 (169) 100.0 (1) 100.0 (1) 92.6 (171)

10.0-14.9 74.5 (397) 81.9 (18) 100.0 (2) 100.0 (1) * (1) 94.0 (419)15.0-19.9 95.2 (474) 74.6 (30) 57.1 (7) * (1) * (1) 93.1 (513)20.0-29.9 96.5 (911) 89.2 (162) 56.1 (81) 13.6 (9) * (11) 91.3 (1174)30.0-39.9 90.9 (628) 67.0 (222) 44.0 (152) 14.6 (33) * (16) 75.2 (1051)40.0-79.9 82.8 (1074) 51.2 (1018) 29.5 (1123) 14.3 (307) 10.0 (183) 48.9 (3705)80.0- 64.9 (311) 36.9 (484) 18.7 (680) 10.4 (202) 7.5 (223) 28.9 (1900)

Total 88.7 (3990) 53.0 (1935) 28.1 (2046) 13.1 (553) 8.5 (435)

Results are percents and, in parentheses, number of patients.*Censored.

Table n-5.55. Five-year survival rates by wall, invasion, tumor size, and lymph node metastasis (12th edition)

Tumor size (mm) NO Nl N2 N3 N4 Total

Wall Invasion =M

--4.9 94.6 (21) 0 94.6 (21)5.0-9.9 93.6 (129) 100.0 (1) 93.6 (130)

10.0-14.9 94.4 (250) 100.0 (3) 94.4 (253)15.0-19.9 96.0 (260) 100.0 (1) 96.0 (261)20.0-29.9 98.1 (418) 100.0 (6) 98.4 (424)30.0-39.9 95.5 (227) 100.0 (8) 100.0 (1) 95.7 (236)40.0-79.9 93.8 (235) 100.0 (8) 100.0 (6) 94.1 (249)80.0- 94.6 (22) 100.0 (1) 50.0 (2) 91.2 (25)Total 95.6 (1562) 100.0 (27) 90.0 (10) 95.7 (1599)

Wall Invasion =SM

--4.9 100.0 (5) 100.0 (5)5.0-9.9 89.7 (32) 100.0 (1) 90.0 (33)

10.0-14.9 96.6 (114) 71.5 (12) 100.0 (1) 94.2 (128)15.0-19.9 94.3 (155) 828 (16) 100.0 (2) 93.5 (173)20.0-29.9 96.3 (296) 89.5 (52) 67.8 (26) 0(1) 93.5 (375)30.0-39.9 94.2 (183) 89.0 (39) 82.2 (12) 0(2) 0(1) 91.9 (237)40.0-79.9 97.9 (194) 82.7 (61) 75.2 (30) 66.7 (6) 0(1) 91.4 (292)80.0- 85.2 (37) 88.9 (10) 16.7 (6) 0(1) 0(1) 78.4 (54)Total 95.5 (1016) 85.6 (191) 70.3 (77) 41.7 (9) (42.8)* (4) 92.0 (1297)

Wall Invasion =MP

--4.95.0-9.9 100.0 (3) 100.0 (3)

10.0-14.9 87.5 (18) 100.0 (3) 100.0 (1) 90.0 (22)15.0-19.9 94.2 (39) 80.0 (7) 33.3 (3) 0(1) 0(1) 84.5 (51)20.0-29.9 97.8 (111) 93.4 (52) 59.1 (22) 0(3) * (4) 88.9 (192)30.0-39.9 89.3 (88) 76.7 (54) 63.8 (32) 37.5 (10) 0(3) 77.2 (187)40.0-79.9 89.1 (152) 76.7 (133) 56.9 (73) 33.6 (16) 60.0 (6) 75.8 (380)80.0- 78.0 (24) 61.9 (21) 25.0 (16) 0(3) 50.0 (2) 54.9 (66)Total 91.0 (435) 78.8 (270) 54.5 (146) 29.6 (34) 38.7 (16) 78.0 (901)

Wall Invasion =SS

--4.95.0-9.9

10.0-14.9 80.0 (6) 80.0 (6)15.0-19.9 100.0 (12) 50.0 (4) 0(1) 80.7 (17)20.0-29.9 97.9 (49) 88.1 (35) 58.2 (17) * (3) * (3) 82.4 (107)30.0-39.0 84.4 (83) 64.3 (66) 33.1 (51) 10.0 (10) * (8) 60.2 (218)40.0-79.9 74.1 (284) 51.2 (369) 35.0 (359) 12.8 (99) 8.8 (44) 47.2 (1155)80.0- 69.6 (103) 50.4 (133) 33.8 (127) 17.4 (36) 18.9 (23) 45.7 (422)Total 77.4 (537) 54.5 (607) 35.3 (555) 13.7 (148) 11.1 (78) 50.6 (1925)

Wall Invasion =SE

--4.95.0-9.9 100.0 (1) 100.0 (1)

10.0-14.9 100.0 (2) 100.0 (1) 100.0 (3)15.0-19.9 75.0 (4) * (1) 100.0 (1) 66.7 (6)20.0-29.9 69.9 (27) 73.3 (15) 33.7 (16) 50.0 (2) * (3) 57.9 (63)30.0-39.9 66.1 (38) 42.2 (52) 33.2 (54) * (10) * (4) 41.0 (158)40.0-79.9 65.4 (193) 39.2 (428) 21.4 (613) 13.9 (159) 8.2 (111) 30.6 (1504)80.0- 47.7 (111) 28.5 (293) 15.4 (467) 9.6 (133) 6.1 (154) 20.2 (1158)Total 61.0 (376) 36.1 (789) 19.8 (1152) 11.9 (304) 6.8 (272) 27.8 (2893)

Wall Invasion =SI, SEI

--4.95.0-9.9

10.0-14.915.0-15.920.0-29.930.0-39.9 * (1) * (1) 0(1) 0(3)40.0-79.9 28.6 (7) 20.0 (15) 9.9 (37) * (25) * (14) 9.7 (98)80.0 29.9 (11) 13.0 (23) 8.5 (59) 5.3 (28) * (42) 7.9 (163)Total 28.6 (18) 15.4 (39) 8.8 (97) 2.5 (54) * (56) 8.5 (264)

*Censored.


Table n-5.56. Five-year survival rates by wall invasion, tumor location, and type of resectionTumor site Type of resection

Distal g Proximal Total Sum.

All Cases

Cardia 35.2 (187) 21.0 (536) 24.9 (723)Upper 85.9 (131) 84.8 (236) 57.3 (600) 68.1 (976)Middle 78.3 (2562) 88.8 (22) 43.9 (721) 71.4 (3418)Lower 51.3 (3317) 19.9 (199) 49.7 (3536)Whole 30.0 (310) 20.0 (5) 24.3 (780) 26.0 (1095)

+142 (missing data) Total 61.8 (6320) 62.5 (450) 35.2 (2836)

Wall Invasion =M

Cardia 100.0 (6) 100.0 (6)Upper 95.2 (43) 96.9 (65) 93.8 (53) 95.4 (165)Middle 96.6 (831) 89.5 (11) 91.0 (39) 96.3 (966)Lower 94.4 (441) 100.0 (3) 94.5 (453)Whole 100.0 (14) 86.2 (15) 93.0 (29)

+98 (missing data) Total 95.9 (1329) 95.9 (82) 91.8 (110) 95.7 (1619)

Wall Invasion =SM

Cardia 71.4 (7) 100.0 (5) 81.3 (12)Upper 100.0 (44) 95.2 (71) 91.1 (76) 94.8 (194)Middle 93.1 (578) 71.4 (4) 88.1 (45) 92.6 (644)Lower 89.3 (391) 66.7 (3) 89.3 (403)Whole 96.0 (25) 87.5 (27) 91.8 (52)


Wall Invasion =MP

Cardia 89.4 (11) 29.0 (15) 54.5 (25)Upper 75.8 (17) 89.9 (30) 79.2 (59) 81.5 (106)Middle 86.2 (284) * (1) 78.5 (46) 85.3 (331)Lower 72.4 (415) 26.7 (10) 71.3 (425)Whole 60.0 (10) 69.9 (14) 65.9 (24)


Wall Invasion =SS

Cardia 39.7 (65) 31.2 (138) 33.9Upper 61.5 (13) 64.9 (32) 61.1 (140) 61.8Middle 61.6 (366) 100.0 (2) 52.0 (185) 58.5Lower 42.7 (927) 26.0 (45) 41.9Whole 45.2 (62) 38.1 (90) 41.0Total 48.0 (1368) 48.7 (99) 45.1 (598) 47.2 (2067) +2

Wall Invasion =SE

Cardia 19.8 (86) 17.4 (302) 18.0Upper 41.7 (12) 57.2 (26) 35.3 (238) 37.7Middle 35.5 (433) 100.0 (3) 28.0 (361) 32.5Lower 22.4 (1034) 16.2 (126) 21.7Whole 10.7 (187) 33.3 (3) 18.1 (564) 16.3Total 24.6 (1666) 30.6 (118) 22.7 (1591) 24.0 (3375)

Wall Invasion =SI, SE1

Cardia 12.5 (8) 7.3 (66) 7.9 (74)Upper * (3) 7.4 (22) 6.3 (25)Middle 15.4 (13) 11.5 (37) 12.6 (50)Lower 7.2 (61) * (10) 6.1 (71)Whole * (11) * (2) 6.5 (66) 5.2 (79)Total 7.6 (85) 7.7 (13) 7.4 (201) 7.5 (299)

* Censored.


Table 11-5.57. Five-year survival rates according to clinicalstage (13th edition) and lymph node metastasis

Clinical stage NO Nl N2 N3 Total

Ia 95.6 95.6Ib 84.0 88.7 77.8 84.8II 64.8 67.2 50.1 100.0 65.5lIla 30.9 48.8 29.9 31.7 43.6lIIb 30.3 20.0 13.8 24.0IV 10.0 9.4 7.7 3.3 7.0

88.4 44.8 17.4 6.9 55.6

Results are percents.

Table 11-5.58. Multivariate analysis of main prognostic factors on prognosis: Cox' proportional hazard model, n = 8822 (allresected cases with single cancer and single lesion: missing 933 data)

Variable DF Parameter estimate Standard error Wald (chi-square) P chi-square Risk ratio

Male 0.114104 0.03071 13.80480 >0.0002 1.121Female 0 1.000

Age < 30 0.118476 0.15166 0.61029 >0.4347 1.12630-39 0 1.00040-49 0.097667 0.06730 2.10592 >0.1467 1.10350-59 0.358741 0.06348 31.94066 >0.0001 1.43260-69 0.693925 0.06333 120.07904 >0.0001 2.00270-79 0.869085 0.07163 147.21631 >0.0001 2.38580-- 0.947533 0.13743 47.53803 >0.0001 2.579

CurabilityA 0 1.000B 0.240293 0.06475 13.77225 >0.0002 1.272C 1.195938 0.09447 160.25318 >0.0001 3.307

Chemo(-) 0.357110 0.03545 101.45156 >0.0001 1.429Chemo(+) 0 1.000

Tumor locationUpper 0.232464 0.06756 11.84065 >0.0006 1.262Middle 0 1.000Lower 0.034461 0.05430 0.40280 >0.5256 1.035Whole 0.203813 0.05401 14.23799 >0.0002 1.226

Tumor sizeLarge 0.515220 0.05888 76.56062 >0.0001 1.674Medium 0.300724 0.05382 31.22410 >0.0001 1.351Small 0 1.000

Tumor type0--1,6 0 1.0002 0.284500 0.05717 24.76300 >0.0001 1.3293 0.467111 0.05448 73.50268 >0.0001 1.5954 0.762870 0.06247 149.10752 >0.0001 2.144

Liver metastasisHO 0 1.000HI 0.548338 0.12288 19.91288 >0.0001 1.730H2 0.299033 0.13300 5.05504 >0.0246 1.349H3 1.153049 0.15494 55.38178 >0.0001 3.168

Lymph node metastasisNO 0 1.000Nl 1 0.262822 0.05963 19.42846 >0.0001 1.301N2 1 0.646539 0.07398 76.37990 >0.0001 1.909N3 1 1.103691 0.08564 166.08196 >0.0001 3.015N4 1 1.104716 0.09548 133.87139 >0.0001 3.018



Variable DF Parameter estimate Standard error Wald (chi-square) P chi-square

Peritoneal disseminationPO 0PI 1 0.665621 0.07072 88.58371 >0.0001P2 1 0.385101 0.07532 26.14294 >0.0001P3 1 0.615077 0.12587 23.88056 >0.0001

Distal metastasisDO 0D1 0.926428 0.26252 12.45370 >0.0004D2 0.564752 0.24766 5.19989 >0.0226D3 0.408403 0.24547 2.76812 >0.0962D4 0.350641 0.24923 1.97930 >0.1595

Wall invasionM-SM 0MP 1 0.579012 0.06635 76.15668 >0.0001SS 1 0.836926 0.07282 132.10528 >0.0001SE- 1 1.197212 0.09848 147.78200 >0.0001

6. Recurrence

Table 11-6.1. Main causes of death, single cancer lesion

Cause Frequency Cumulative frequency

Alive or unknown 4324 4324Relapse 2842 7166Other cancer 34 7200Noncancer death 625 7825Unknown 1767 9592Direct death 163 9755

Risk ratio

1.0001.9461.4701.850

1.0002.5251.7591.5041.420

1.0001.7842.3093.311

Table 11-6.2. Cell differentiation and types of recurrence, single cancer lesion

Differentiation Alive or Peritonitis Liver metastasis Local recurrence Remnant Distant Misc. Totalunknown stomach metastasis

Unknown 173 4 1 2 0 7 0 187(92.51) (2.14) (0.53) (1.07) (0.00) (3.74) (0.00) (1.92)

Differentiated 3489 164 369 159 14 129 1 4325(80.67) (3.79) (8.53) (3.68) (0.32) (2.98) (002) (44.34)

Undifferentiated 3857 691 219 229 40 205 2 5243(73.56) (13.18) (4.18) (4.37) (0.76) (3.91) (0.04) (53.75)

Total 7519 859 589 390 54 341 3 9755(77.69) (8.81 ) (6.04) (4.00) (0.55) (3.50) (0.03)

Results in Tables II-6.2 through 11-6.16 are expressed as the number of patients and percents.(%)

Background Factor· Recurrence 263

Table 11-6.3. Wall invasion and types of recurrence, single cancer lesion

Wall Alive or Peritionitis Liver Local Remnant Distant Misc. Totalinvasion unknown metastasis recurrence stomach metastasis

Unknown 153 3 2 2 0 7 0 167

(91.62) (1.80) (1.20) (1.20) (0) (4.19) (0) (1.71)

M 1610 0 5 2 0 2 0 1619(99.44) (0) (0.31) (0.12) (0) (0.12) (0) (16.60)

SM 1262 5 22 2 4 11 0 1306(96.63) (0.38) (1.68) (0.15) (0.31) (0.84) (0) (13.39)

MP 827 9 41 15 8 16 0 916

(90.28) (0.98) (4.48) (1.64) (0.87) (1.75) (0) (9.39)

SS 1625 101 184 79 9 68 1 2067

(78.62) (4.89) (8.90) (3.82) (0.44) (3.29) (0.05) (21.19)

SE 1878 688 309 262 32 211 1 3381

(55.55) (20.35) (9.14) (7.75) (0.95) (6.24) (0.03) (34.66)

SI-SEI 164 53 26 28 1 26 1 299(54.85) (17.73) (8.70) (9.36) (0.33) (8.70) (0.33) (3.07)

Total 7519 859 589 390 54 341 3 9755(77.08) (8.81) (6.64) (4.00) (0.55) (3.50) (0.03)

(%)

Table 11-6.4. Causes of postoperative deaths, single cancer lesion

Condition 1946-1949 1950-1959 1960-1969 1970-1979 1980-1989 1990- Total

Alive 8 160 382 864 1411 1499 4324

Relapse 64 496 791 691 634 166 2842(33.86) (34.47) (52.11) (62.08) (66.32) (76.85) (29.13)

Other cancer 0 0 11 11 9 3 34(0) (0) (0.72) (0.99) (0.94) (1.39) (0.35)

Noncancer death 15 120 257 146 68 19 625(7.94) (8.34) (16.93) (13.12) (7.11 ) (8.80) (6.41)

Unknown 97 776 395 246 234 19 1767(51.32) (53.93) (26.02) (22.10) (24.48) (8.80) (18.11 )

Direct death 13 47 64 19 11 9 163(6.88) (3.27) (4.22) (1.71) (1.15) (4.17) (1.67)

Total 197 1599 1900 1977 2367 1715 9755(2.02) (16.39) (19.48) (20.27) (24.26) (17.58)

(%)

Table 11-6.5. Recurrent types of peritoneal dissemination, single cancer lesion

Type 1946-1949 1950-1959 1960-1969 1970-1979 1980-1989 1990- Total

None 195 1538 1591 1640 2030 1624 8618(98.98) (96.19) (83.74) (82.95) (85.76) (94.69) (88.34)

. . . . .. . .. ........

Knobby 0 0 34 49 48 7 138(0) (0) (1.79) (2.48) (2.03) (0.41) (1.41 )

Disseminated 0 50 275 285 223 50 883(0) (3.13) (14.47) (14.42) (9.42) (2.92) (9.05)

Kruckenberg 0 6 0 2 9 4 21(0) (0.38) (0) (0.10) (0.38) (0.23) (0.22)

Douglas 2 5 0 1 57 30 95(1.02) (0.31 ) (0) (0.05) (2.41) (1.75) (0.97)

Total 197 1599 1900 1977 2367 1715 9755(2.02) (16.39) (19.48) (20.24) (24.26) (17.58)

(%)


Table 11-6.6. Recurrent types of hematogenous metastasis, single cancer lesionRecurrence 1946-1949 1950-1959 1960-1969 1970-1979 1980-1989 1990- Total

None 192 1507 1704 1776 2184 1652 9015

.. . ...... .. . .. ........ ... (97:46) (94.25) ........... (89:68) (89.83) (92.27) (96:33) (92.41)..................... . ........................

Liver 5 78 161 135 114 44 537(2.54) (4.88) (8.47) (6.83) (4.82) (2.57) (5.50)

Lung 0 3 34 62 49 6 154(0) (0.19) (1.79) (3.14) (2.07) (0.35) (1.58)

Bone 0 6 0 2 11 9 28(0) (0.38) (0) (0.10) (0.46) (0.52) (0.29)

Brain 0 2 0 1 3 0 6(0) (0.13) (0) (0.05) (0.13) (0) (0.06)

Skin 0 1 1 1 3 3 9(0) (0.06) (0.05) (0.05) (0.13) (0.17) (0.09)

Misc. 0 2 0 0 3 1 6(0) (0.13) (0) (0) (0.13) (0.06) (0.06)

Total 197 1599 1900 1977 2367 1715 9755(2.02) (16.39) (19.48) (20.27) (24.26) (17.58)

(%)

Table 11-6.7. Types of local recurrence, single cancer lesionRecurrence 1946-1949 1950-1959 1960-1969 1970-1979 1980-1989 1990- Total

None 193 1576 1734 1827 2278 1689 9297(97.97) (98.56) (91.26) (92.41) (96.24) (98.48) (95.30).... . . . . . . .. . . .. .. ... ... .... .. . . . . .. .. ..•......

Perigastric 0 11 144 122 38 6 321(0) (0.69) (7.58) (6.17) (1.61) (0.35) (3.29)

Liver hilus 1 9 18 26 39 17 110(0.51) (0.56) (0.95) (1.32) (1.65) (0.99) (1.13)

Abdominal wall 2 2 3 2 9 2 20(1.02) (0.13) (0.16) (0.10) (0.38) (0.12) (0.21 )

Misc. 1 1 1 0 3 1 7(0.51) (0.06) (0.05) (0) (0.13) (0.06) (0.07)

Total 197 1599 1900 1977 2367 1715 9755(2.02) (16.39) (19.48) (20.27) (24.26) (17.58)

(%)

Table 11-6.8. Recurrent types in the residual stomach, single cancer lesionRecurrence 1946-1949 1950-1959 1960-1969 1970-1979 1980-1989 1990- Total

None 195 1593 1877 1957 2357 1713 9692(98.98) (99.62) (98.79) (98.99) (99.58) (99.88) (99.35)

Stoma 1 1 9 11 6 1 29(0.51) (0.06) (0.47) (0.56) (0.25) (0.06) (0.30)

Stump 1 5 14 9 4 1 34(0.51) (0.31) (0.74) (0.46) (0.17) (0.06) (0.35)

Total 197 1599 1900 1977 2367 1715 9755(2.02) (16.39) (19.48) (20.27) (24.26) (17.58)

(%)


Table 11-6.9. Recurrent types of distant metastasis, single cancer lesion

Recurrence 1946-1949 1950-1959 1960-1969 1970-1979 1980-1989 1990- Total

None 193 1585 1811 1918 2244 1663 9414(97.97) (99.12) (95.32) (97.02) (94.80) (96.97) (96.50)

Virchow 1 6 16 20 29 7 79(0.51) (0.38) (0.84) (1.01) (1.23) (0.41) (0.81)

Inguinal 1 0 2 2 2 1 8(0.51 ) (0) (0.11 ) (0.10) (0.08) (0.06) (0.08)

Pulmonary 0 0 0 5 7 3 15lymphangitis (0) (0) (0) (0.25) (0.30) (0.17) (0.18)

Paraaorta 2 8 71 32 85 41 239(1.02) (0.50) (3.74) (1.62) (3.59) (2.39) (2.45)

Total 197 1599 1900 1977 2367 1715 9755(2.02) (16.39) (19.48) (20.27) (24.26) (17.58)

(%)

Table 11-6.10. Chemotherapy for peritoneral dissemination, single cancer lesion

Dissemination Unknown None Single drug Multidrug Total

None 7593 820 74 131 8618(88.11 ) (9.51) (0.86) (1.52) (88.34)

Knobby 11 68 24 35 138(7.97) (49.28) (17.39) (25.36) (1.41)

Disseminated 140 541 74 128 883(15.86) (61.27) (8.38) (14.50) (9.05)

Kruckenberg 8 1 2 10 21(38.10) (4.76) (9.52) (47.62) (0.22)

Douglas 32 22 9 32 95(33.68) (23.16) (9.47) (33.68) (0.97)

Total 7784 1452 183 336 9755(79.79) (14.89) (1.88) (3.44)

(%)

Table 11-6.11. Chemotherapy for hematogenous metastasis,single cancer lesion

Metastasis Unknown None Single Multidrug Totaldrug

None 7598 1073 114 230 9015

... , ......... ,(84.28) (11.90) (1.26) (2.55) (92.41)

Liver 141 287 44 65 537(26.26) (53.45) (8.19) (12.10) (5.50)

Lung 21 83 19 31 154(13.64) (53.90) (12.34) (20.13) (1.58)

Bone 15 5 4 4 28(53.57) (17.86) (14.29) (14.29) (0.29)

Brain 4 0 1 1 6(66.67) (0) (16.67) (16.67) (0.06)

Skin 3 2 1 3 9(33.33) (22.22) (11.11) (33.33) (0.09)

Misc. 2 2 0 2 6(33.33) (33.33) (0) (33.33) (0.06)

Total 7784 1452 183 336 9755(79.79) (14.89) (1.88) (3.44)

(%)


Table 11-6.12. Reoperation for recurrence in the residual stomach, single cancer lesion

Recurrence None Radical Palliative Bypass Jejunostomy Colostomy Misc. Total

None 9433 26 48 82 24 47 32 9692(97.33) (0.27) (0.50) (0.85) (0.25) (0.48) (0.33) (99.35)

...................................................................................

Stoma 20 0 5 4 0 0 0 29(68.97) (0) (17.24) (13.79) (0) (0) (0) (0.30)

Stump 19 4 5 4 2 0 0 34(55.88) (11.76) (14.71) (11.76) (5.88) (0) (0) (0.35)

Total 9472 30 58 90 26 47 32 9755(97.10) (0.31) (0.59) (0.92) (0.27) (0.48) (0.33)

(%)

Table 11-6.13. Chemotherapy for recurrence in the residualstomach, single cancer lesion

Recurrence Unknown None Single Multidrug Totaldrug

None 7773 1421 174 324 9692(80.20) (14.66) (1.80) (3.34) (99.35)

. . . . . . . . . . . . . . . .... ...... . .. .

Stoma 3 15 5 6 29(10.34) (51.72) (17.24) (20.69) (0.30)

Stump 8 16 4 6 34(23.53) (47.06) (11.76) (17.65) (0.35)

Total 7784 1452 183 336 9755(79.79) (14.88) (1.88) (3.44)

(%)

Table 11-6.14. Reoperation according to the main recurrent types, single cancer lesion

Recurrence No surgery Radical Palliative Bypass Jejunostomy Colostomy Misc. Total

None or unknown 7500 3 2 3 6 3 2 7519(99.75) (0.04) (0.03) (0.04) (0.08) (0.04) (0.03) (77.08)

. . . .. ...........•...

Peritonitis 716 9 28 52 11 36 7 859(83.35) (1.05) (3.26) (6.05) (1.28) (4.19) (0.81) (8.81)

Liver metastasis 566 7 3 3 2 2 6 589(96.10) (1.19) (0.51) (0.51) (0.34) (0.34) (1.02) (6.04)

Local recurrence 342 3 12 21 1 2 9 390(87.69) (0.77) (3.08) (5.38) (0.26) (0.51) (2.31) (4.00)

Remnant stomach 33 4 8 7 2 0 0 54(61.11) (7.41) (14.81 ) (12.96) (3.70) (0) (0) (0.55)

Distant metastasis 312 4 5 4 4 4 8 341(91.50) (1.17) (1.47) (1.17) (1.17) (1.17) (2.35) (3.50)

Miscellaneous 3 0 0 0 0 0 0 3(100.00) (0) (0) (0) (0) (0) (0) (0.03)

Total 9472 30 58 90 26 47 32 9755(97.10) (0.31 ) (0.59) (0.92) (0.27) (0.48) (0.33)

(%)


Table 11-6.15. Chemotherapy according to the main recurrent types, single cancer lesion

Recurrence Unknown None Single drug Multidrug Total

None or unknown 7332 178 5 4 7519(97.51) (2.37) (0.07) (0.05) (77.08)

......................

Peritonitis 157 493 64 145 859(18.28) (57.39) (7.45) (16.88) (8.81)

Liver metastasis 158 314 44 73 589(26.83) (53.31) (7.47) (12.39) (6.04)

Local recurrence 59 262 27 42 390(15.13) (67.18) (6.92) (10.77) (4.00)

Remnant stomach 11 27 8 8 54(20.37) (50.00) (14.81) (14.81) (0.55)

Distant metastasis 65 177 35 64 341(19.06) (51.91) (10.26) (18.77) (3.50)

Miscellaneous 2 1 0 0 3(66.67) (33.33) (0) (0) (0.03)

Total 7784 1452 183 336 9755(79.79) (14.89) (1.88) (3.44)

('Yo)

Table 11-6.16. Radiation therapy according to the main typeof recurrence, single cancer lesion

Recurrence Unknown None Yes Total

None or unknown 7332 183 4 7519(97.86) (2.14) (77.08)

Peritonitis 168 678 13 859(98.12) (1.88) (8.81)

Liver metastasis 166 400 23 589(94.56) (5.44) (6.04)

Local recurrence 60 307 23 390(93.03) (6.97) (4.00)

Remnant stomach 12 35 7 54(83.33) (16.67) (0.55)

Distant metastasis 72 231 38 341(85.87) (14.13) (3.50)

Miscellaneous 2 1 0 3(100.00) (0) (0.03)

Total 7812 1835 108 9755(80.08) (18.81) (1.11 )

('Yo)

Subject Index

A7-NCS 183activated carbon 45,46

-particle 50adeno-associated virus 187adenovirus 187adhesion 186adjuvant chemoimmunotherapy

18adjuvant chemotherapy 3, 131,

144, 181-for gastric cancer in Western

countries 32-for noncurative surgery 37-for serosa-negative gastric

cancer 35,38-for serosa-positive gastric

cancer 37,38stndard-for gastric cancer 27-with MFC-related regimen

34adjuvant therapy with high doses

of mitomycin C 18adverse drug reaction 66adverse effect 98angiogenesis 115,170,177,178angiogenic factor 170angiotensin II-induced

hypertension chemotherapy90

anti-C03 172anti-C068 172antiangiogenic agent 181antiangiogenic therapy 174antibody 173

-A-20 178antisense RNA 173area under the curve (AUe) 59arterial blood pressure 90arterial port 108assessment of tumor volume and

surgical cytoreduction 74Austrian Working Group for

Surgical Oncology(AWGSO) 22

basic fibroblast growth factor 170biochemical modulation 51, 108blood flow 90Borrmann type 4 56British Stomach Cancer Group

(BSCG) 21,22

CA19-9 141,149cancer cell migration 177carmistine (BCNU) 18COOP + 5-FU 39CEA 141,149cell cycle 3cell-suspension assay 165cellular toxicity 188charcoal-adsorbed mitomycin C

184chemohyperthermic peritoneal

perfusion (CHPP) 71chemoprotective gene 187chemoresistant clone 115chemosensitivity 129, 165

-test-guided adjuvantchemotherapy 168

chi-square test 156cis-diammine dichloroplatinum

(COOP) 66cisplatin (COOP) 131,163

low-dose- 151pharmakokinetics of- 66

combination chemotherapy 104combined-regimen chemotherapy

163complete remission (CR) 149complete response 136complete tumor resection 141complication 159

computed tomographicangiography (CTA) 84

confidence interval (CI) 27continuous hyperthermic

peritoneal perfusion(CHPP) 12

continuous infusion 151criteria of the Japanese Research

Society for Gastric Cancer132

curative resection rate 122cytokeratin 177cytosine deaminase (CD) gene

187, 191cytotoxic activity 185

DerSimonian-Laird method 27diffuse-type gastric tumor 171dinitrochlorobenzene (ONCB) 19DNA-repair gene 190dose intensity 5

-of the adjuvant cancerchemotherapy 164

down~stage 122down-staging 116,117,141drug concentration in tumor 136drug delivery system 45,90

EAP 24,84,101,109,116,118,122

early chemotherapy 5early gastric cancer 181early postoperative intraperitoneal

chemotherapy 74Eastern Cooperative Oncology

Group (ECOG) 17-scale 141

EDso 48,50effect of adjuvant cancer

chemotherapy 167

269

270 Subject Index

EFP 101, 116, 122ELF 84,101end-stage 156endothelial cell 172European Organization for the

Research and Treatment ofCancer (EORTC) 19

exclusion criteria 13external beam radiation therapy

(EBRT) 21

FAM (5-fluorouracilldoxorubicin/mitomycin C) 19,32,84

FAM2 19FAMTX 63,84, 109, 117FEM (5-FU/etoposide/MMC) 19,

32five-year survival rates by

histological grading 128FLEP (5-FU/leucovorin/etoposide/

cisplatinum) 39,97,101,104,108,109,119

FLP therapy 141,148FLPO 148fluoropyrimidine 1395-fluorouracil (5-FU) 75-fluorouracilladriamycin/cisplatin

(FAP) 1315-FU concentration 1395-FU plus leucovorin 1305-FU tablet 126FP 84FT 132

G-protein 188Gastric Cancer Surgical Study

Group (GCSSG) 32Gastrointestinal Tumor Study

Group (GITSG) 17,32gene therapy 187gene transfer 187generalized Wilcoxon test 156,166good clinical practice (GCP) 5

H-ras 191hematological toxicity 149hepatic arterial infusion

chemotherapy 84hepatic resection 83herpes simplex virus thymidine

kinase gene 190

histological change 100, 126, 130histological response 135histopathological effect 128human anti-mouse antibody 186human immunodeficiency virus

188human/mouse chimeric antibody

186hybridoma technique 185

immune cell 172immune surveillance 189immunochemotherapy 148immunoconjugate 186immunogenicity 188immunotargeting chemotherapy

183implantable port system 84, 90implantable vascular access device

97in vitro cytotoxicity 184incurable gastric cancer 97informed consent 6inhibition rate 164intermediate-dose 51International Cancer Collaborating

Group (ICCG) 19interventional angiography 84intestinal-type tumor 171intraarterial BCNU 24intraarterial regional

chemotherapy 93intrahepatic chemotherapy 90intraoperative lavage cytology

150intraoperative local infusion

chemotherapy (ILIC) 154intraoperative radiotherapy

(IORT) 21intraperitoneal administration 45intraperitoneal chemotherapy 22,

58intraoperative and post

operative- 38-with cisplatin (CDDP) 58-with MMC 58

intraperitoneal injection 185intraperitoneally administered

anticancer drug 184

Japan Clinical Oncology Group(JCOG) 7,32

Japanese adjuvant trials for gastriccancer 7

Japanese Hepatic Arterial InfusionStudy Group (JHAISG)85

K-ras 190XZ test 156Kaplan-Meier method 133

LDso 48,50leucovorin (LV) 141local administration of anticancer

drug 68local infusion chemotherapy 154local response to chemotherapy

98locoregional intensive

chemotherapy 157lymph node dissection 155, 167

Dz- 168prophylactic- 181

M.D. Anderson Cancer Center(MDA) 23

macrophage-mediated immunity151

macroscopic and microscopicchange 100

macroscopic response 135major complication 143major histocompatibility complex

189Mann-Whitney U-tests 133Mantel-Haenszel method 27matched-pair control method 155Mayo Clinic 21measurement of MTX 52median survival time 143Memorial-Sloan Kettering Cancer

Center (MSKCC) 24meta-analysis 27, 115metastasis

accelerated growth of- 115bone or skeleton- 179hematogenous- 170liver- 83lymph node- 39, 150, 177peritoneal- 150

metastatic growth in skeletalsystem 181

method of Taylor seriesapproximation 27

methotrexate (MTX)/5-FU 37,118,123

methyl-CCNU 17,32MF+ UFT 39MFC 12MFLP-F 101micrometastasis 179microvessel density 178milky spots 47MMC 7,45,46,47,48,49,50

-adsorbed to activated carbonparticles (M-CH) 12

MMC-CH 45,46,47,48,49,50monoclonal antibody 177monoclonal antibody A7 183MRSA 138MIT assay 164multicenter Italian study 20multivariate analysis 36myelosuppression 145myelosuppressive

chemotherapeutic agent190

-preoperative 118

neoadjuvant chemotherapy (NAC)105,108,129,141

neoadjuvant (preoperative)chemotherapy 115

neoadjuvant therapy 23, 150neoadjuvant UFT 134, 138neovascularization 115noncurative resection 144

odds ratio 27OK432 7oncogene 192oral aphthae 151oral chemotherapy 35

p53 190Papanicolaou staining 179partial response (PR) 149pathologic complete response

122pathological complete remission

(pCR) 104PCNA-specific antisense

oligonucleotide 192

percutaneous catheter placement84

performance status 131peritoneal

-carcinomatosis 45, 46, 48-dissemination 145-lavage cytology 59-recurrence 49,50-reservoir 66

peritonectomy 71, 73-combined with intraperitoneal

chemotherapy orhyperthermia 71

Peto method 27pharmacokinetics 45

-of intraperitoneal MMC 59-of the drug 159-ofCDDP 66-of intraperitoneal CDDP 61

phase II study 163platelet-derived endothelial cell

growth factor 170platinum

-concentration 157urinary- 158

PMFE 71PMUE 118poorly differentiated

adenocarcinoma withmedullary growth (porI)93

postoperative-adjuvant chemotherapy 17,

129-adjuvant chemotherapy in

Japan 32-complication 75-intraperitoneal (IP)

chemotherapy 66,117-intraperitoneal therapy 123-recurrence 45

postsurgical-liver dysfunction 139-pathology 136-stage classification 132-survival 137

preliminary study 151preoperative

-adjuvant chemotherapy 129-chemoradiotherapy 123-chemotherapy 105, 122, 126-chemotherapy for potentially

resectable gastric cancer116

Subject Index 271

-chemotherapy for unresectablegastric cancer 117

-cis-platin, 5FU, and interferon-alpha (CFI) 123

-EAP 117-hyperthermia 21-staging 111-therapy 122

proliferating cell nuclear antigen(PCNA) 192

prospective randomized controlledtrial 167

PSK 7pTNM classification 155

quality of life 138-after peritonectomy 77

RO 122radiation therapy 21radio-immunoimaging 183radiochemotherapy 21randomization 13randomized

-controlled multicenter clinicalstudy 126

-controlled study 168-controlled trials (RCTs) 7-controlled trials (RCTs) in the

JCOG study 34receptor-ligand system 171recombinant viral vector 188reduction of the viability of cancer

141regional chemotherapy 88

-for liver metastasis 100resectability rate 143residual tumor burden 3responding fraction 4response rate 99,101,142retroviral vector 188retrovirus 187route of administration 108

sample size 13sclerosing encapsulating peritonitis

63second-look operation 157semustine 17sequential MTX/5-FU 51,142single-agent therapy 163

272 Subject Index

social support system 124South African trial 22Southwest Oncology Group

(SWOG) 19staging

clinical- 124-laparoscopy 123preoperative- 111pretreatment- 101

standard adjuvant chemotherapyfor gastric cancer 27

subset analysis 13suicide gene therapy 189support system 6suppressor gene 192surgery-alone arm 7surgery-related metastasis 159surgical quality control 17survival benefit 4, 129survival curve 49, 137survival rate 179systematic lymphadenectomy

141systemic chemotherapy 83systemic PMUE 71

therapeutic efficacy 48,49,52therapeutic index 48, 50therapeutic strategy for liver

metastasis 87[3H]thymidine incorporation 166thymidine kinase (HSV-tk) gene

187total cell kill 3toxic effect 157toxicity 48,101,143treatment-related death 145tumor cell vaccination 189tumor dormancy 173

-therapy 174tumor shrinkage 173tumor-specific gene transfer 191two-route chemotherapy 93

DFf 7,131UICC (TNM) stage classification

132undifferentiated gastric carcinoma

51University of Southern California

(USC) 23University of Vienna 22unresectable gastric cancer 97

vascular endothelial growth factor170

vessel count 170Veterans Administration Surgical

Adjuvant Group (VASAG)17

viral vector 187

well-differentiated type (pap, tub1)93

Western postoperative adjuvanttrials 17

World Health Organization(WHO) standard criteria132

Yoshida sarcoma 45, 46, 46

Documents

Appendix: Tabular Analysis ofCIH (Cancer Institute ...978-4-431-67927-1/1.pdftumor characteristics based on operative findings and histopathological study, and clinical stages according