[Advanced carcinoma of the stomach--I. Prognostically important signs]

Fifty one bioptic cases of resected advanced cancer of the stomach (34 males--mean age 67.8 years 17 females--mean age 75.9 years) were studied in a five-year period (1982-1986). Nine patients (17.6 per cent) has survived without any clinical or laboratory symptoms of disease on average 4 years and 8 months after operation, two patients less than 3 years, seven more than 3 years. Two of them had diffuse type carcinoma (DC), 7 had intestinal type carcinoma (IC) according to Lauren. The group was simultaneously evaluated according to Ming's classification as expansive (infiltrative types of carcinoma respectively. Both classification schemes gave similar results and combined with TNM system yielded sufficient prognostic information. According to the TNM system all cancers (excepting one DC) were stage II. pT2, pNO. IC had as much as 8 cm in diameter (T3), regional lymph nodes in 6 patients produced a favourable type of reaction with predominating lymphocytes of germinal centres mostly combined-with sinus histiocytosis. Absence of lymph node metastasis was more important for prognosis than the favourable type of lymph node reaction.