THE PATHOLOGY AND PROGNOSIS OF GASTRIC CARCINOMA （A STUDY OF 100 RESECTED CASES）

100 surgically resected specimens of gastric carcinoma were studied and analysed with the intention to ascertain the relationship between the pathological changes and prognosis. Several pathological features, such as macroscopical size of the lesion, the depth of cancerous invasion into the gastric wall, the site and mumber of lymph node metastases and the histological appearences were found to have statistically significant relations to the prognosis. While these factors were interrelated with each other, the most basic factor was the depth of carcinomatous infiltration in the gastric wall. In this series, 8 cases in which the tumors limited to the upper part of muscularis Propria were all alive during the follow-up for 2—10 years or more. On the other hand, when the deeper layer of muscularia Propria was involved, the 5-year survival rate was 50%. When the tumors extended into the subserosa, the 5-year survival rate was reduced to 23%, and merely 10% when tumors extended beyond the serosa.
On the basis of this result, we emphasize again that the best management of gastric cancer at present is early diagnosis followed by subsequent surgical removal. Our preliminary histological observations also suggest that the pericancerous lymphocytic infiltr ations were pertinent to a better prognosis. Thus, it is important to find ways and means to enhance the immunity of the patient. Finally this paper also depicts that a thorough examination of a resected specimen is of prime importance for predicting the prognosis.