[Treatment of advanced gastric carcinoma based on histologic type]

It is well known that clinicopathological characteristics in gastric carcinoma are different according to its histologic type, intestinal type or diffuse type. Multivariate analysis of advanced gastric carcinoma revealed that the histologic type significantly related to the type of recurrence, hematogenous metastasis or peritoneal dissemination. Therefore, we introduced a prospective randomized trial for treatment of advanced gastric carcinoma based on histologic type of carcinoma. Intraoperatively, 10 mg of mitomycin C was given via portal system in the intestinal type and given in peritoneal cavity in the diffuse type. As results, in the intestinal type, survival rate in patients with the chemotherapy was longer than that without the chemotherapy, but this did not reach to a significant difference. On the contrary, in the diffuse type, patients with the chemotherapy showed a significant longer survival rate compared to those without the chemotherapy. These results suggests the availability of treatment based on histologic type of carcinoma. Much more selective and effective improvements in this type of treatment will be required.