Strategy for Either Recurrence or Metastasis of Gastric Cancer

In order to improve the outcome of gastric cancer patients, various modalities of treatment were clinically examined. Irrigation cytology during surgery was performed in 233 patients, and positive results were obtained in 10.8% of P0 cases. The survival curve of these patients was lowerthan that of patients with negative cytology results. These patients were thought to be in the stage of microscopic peritoneal dissemination, and intraoperative locoregional immunochemotherapy should be applied to them. The intraoperative subserosal administration of neocarzinostatin (NCS) resulted in a high tissue NCS concentration in the regional lymph nodes. In addition, the positive rate on the chemosensitivity test for NCS was 80.0% in 20 cases. Therefore this treatment might be effective for residual metastatic lymph nodes after surgery, as a means of targeting lymph nodes. Alternatively, the patients with liver metastases were given intermittent transarterial administration of chemotherapeutics and bilological response modifiers (BRM), and fairly good results were obtained followed by prolongation of the survival rate. In conclusion, the above modalities were useful for the prevention of local recurrence, hematogenic metastasis and lymphatogenic metastasis of gastric cancer.