[A study of gastric cancer invasion of the duodenum]

Gastric cancers that have invaded in the duodenum were clinicopathologically studied in 83 patients in an attempt to clarify surgical therapeutic problems. The classification and results are itemized below. 1) The extensive forms of these cancers were found to include the types of continual superficial extension (12 patients), expansion (11), deep-layer (39), whole-layer (9), non-continual extensive intralymphatic duct type (8) and specific type (4). 2) More patients manifesting a deep-layer or intralymphatic duct cancers were Borr. 3 and 4 types with a longer distance of infiltration. All of the 14 patients with an aw (+) showed these patterns of extension. 3) The n3 (+) was more common with Nos. 12, 13 and 14 lymph nodes, and similar results were seen by RI lymphography. Thus, special care may have to be exercised in treating the duodenal stump in the gastric cancers that have invaded the pyloric ring. Pancreato-duodenectomy may be required for the removal of lymph nodes in patients with gastric cancers that show a severe infiltration into the duodenum.