[The problems of postoperative adjuvant chemotherapy in gastric cancer]

We studied the survival rate and state of recurrence of histologically curatively resected cases in the 1st (Method II) and the 2nd studies of the Cooperative Study Group of Surgical Adjuvant Chemotherapy for Gastric Cancer. The administration of MMC combined with Futraful was most effective, but there was no difference of survival rate between the patients in the 1st study given Futraful for 3 months and those in the 2nd study given the drug for 12 months. Irrespective of the kind of drug and term of administration, cases with stage I showing recurrence within 2 years after surgery accounted for ca. 50% of all stage I cases recurring within 5 years. In spite of histological malignancy, cases with stage II showing recurrence within 2 years after surgery accounted for ca. 65% of all stage II cases recurring within 5 years. As to the recurrent hazard rate for each recurrent type of case with stage III, all types showed a high peak between 0.5 and 1.5 years after surgery. The peritoneal metastatic hazard rate was the highest. The hazard rates for Groups B (MMC + Futraful) and C (Futraful) were lower than those for Group A (MMC). The above findings suggest the importance of postoperative adjuvant chemotherapy, which is performed repeatedly and intensively for 2 years in order to prevent recurrence.