[Treatment of macroscopical subtypes in Borrmann type 4 gastric carcinoma]

According to macroscopical appearances of the gastric lesions, we classified Borrmann-4 Type of gastric carcinoma into 4 subtypes; (1) giant rugae type, (2) IIc surface type, (3) erosion type, and (4) stricture type. The important points of treatment for each subtype are as follows: For carcinomas of the giant rugae type and the stricture type, neighboring organs and surrounding tissues of the stomach should be resected with total gastrectomy and a long-term chemotherapy should be performed postoperatively. For IIc surface type and erosion type, regional lymph nodes should be thoroughly cleaned up and the aggressive adjuvant therapies should be given from the early day after the surgical operation.