[Extended operations in cancer--gastric cancer]

Extended operations of combined resection of surrounding organs and lymphadenectomy of the para-aortic lymph nodes for advanced cancer of the stomach were reported. Combined pancreatoduodenectomy for advanced cancer of lower portion was carried out 5.2% (172/3317). 5 year survival rate was 7% (10/141). Nine 5-year survival cases showed direct invasion to pancreas, so this combined resection is significant for such cases. Left upper abdominal evisceration for advanced cancer of upper and middle portion was carried out in 128 cases (1980-1986). 5-year survival rate was 9.4% (3/32). We expect that this extended procedure shows the progress of surgical results on Borrmann 4 type cancer. Para-aortic lymph node dissection was performed in 400 cases during 10 years (1978-87). The rate of lymph node metastases was 31%. Among them, 5-year survival 5 cases survived over 5 years after operation. For advanced cases with lymph node metastases, lymphadenectomy around the abdominal aorta should be performed more aggressively.