Clinicopathologic features of gastric cancer in young women were analyzed with special reference to pregnancy (P). Among 2,325 consecutive patients, there were 152 young patients under 40 years of age (57 males and 95 females), and 14 P-associated cases were identified. The male-to-female ratio was 1.7:1.0 on the whole, but 1.0:1.7 in the young group with more females predominating as the age of patients decreased. Among characteristics of gastric cancer in the young females, we noted a significantly higher frequency of both Borrmann type 4 cancer and poorly differentiated adenocarcinoma with the scirrhus type of growth and peritoneal metastasis. These characteristics were more pronounced in the P-associated cases. Although we were unable to determine the mechanism for these tendencies, our findings suggest that the development and growth of gastric cancer in young women may be influenced by their natural, biological and hormonal circumstances. The prognosis of the young women with or without associated pregnancy was good after curative surgery. Both early detection of gastric cancer and subsequent potentially curative surgery are the best ways to obtain good survival for young women, as is the case for members of other age and sex groups.

The immunomodulative effect of perioperative allogeneic blood transfusion on host immunocompetence was studied in 109 patients with gastric cancer at various stages. Mitogen-induced lymphocyte blastogenesis, lymphocyte surface markers (specific for T, B, CD4, and CD8 populations), and the activity of natural killer (NK) cells were examined before surgery and then 2 and 4 weeks after surgery. The effects on host immunocompetence of transfusion alone, in the absence of any effect of surgical stress, were studied, preoperatively, in nine patients who received preoperative transfusion. Although a tendency towards a decrease in the posttransfusion activity of NK cells was observed, there were no statistically significant differences between pre- and posttransfusion levels. Mitogen-induced blastogenesis and the activity of NK cells were significantly impaired 2 weeks after surgery in transfused patients as compared to those in nontransfused patients with gastric cancer at stage III and stage IV, and postoperative survival was significantly lower in transfused as compared to nontransfused patients. These results indicate that perioperative allogeneic blood transfusion exacerbates surgical stress-induced postoperative immunosuppression and has a negative effect on prognosis in patients with gastric cancer.

The relationship between operative procedures for treatment of patients with gastric carcinoma and complications was studied with special reference to the age of patients, who were divided into four groups: 50-59 years; 60-69 years; 70-79 years; and over 80 years. Preoperative risk factors that were common in patients over 70 years of age were hypertension and cardiac disease. The selected operative procedures were similar for each age group. However, neither proximal gastrectomy nor reconstruction by jejunal interposition was selected for patients of 80 years and over. In these patients, resection of the neighbouring organs was seldom performed and lymph node dissection was usually limited to the primary and secondary nodes. There was no significant difference in the rate of postoperative complications between groups. Although only limited surgery was performed for patients of 80 years and over, there was no significant difference in age-corrected cumulative survival rate between groups. Therefore, limited resection and/or lymph node dissection may allow safe surgical treatment for patients of 80 years and over with gastric carcinoma, without any negative effect on prognosis.

We report herein the rare case of a patient who survived for 5 years and 10 months after commencing treatment for gastric cancer with simultaneous disseminated peritoneal metastasis. A 45-year-old man was diagnosed as having advanced gastric cancer following the discovery of numerous nodules in the peritoneal cavity at laparotomy. The patient was treated by palliative gastrectomy and continuous hyperthermic peritoneal perfusion (CHPP) immediately after surgery on November 11, 1987. Postoperatively, he underwent radiofrequency (RF) hyperthermia with intraperitoneal cisplatin a total of seven times. He continued on a combination of uracil and tegafur (UFT) administered orally with a protein-bound beta-D-glucan extracted from the mycelia of Cariolus versicolor (PSK). Long-term survival was achieved following the initial palliative gastrectomy despite simultaneous disseminated peritoneal metastasis.

Background. Dendritic cells (DC), including epidermal Langerhans cells, are potent antigen‐presenting cells that can carry and present tumor antigens to helper T‐cells. An immunohistochemical study was performed to clarify the relationship between the extent of infiltration by DCs in primary gastric cancer and that in the regional lymph nodes. Methods. Paraffin blocks were prepared for staining with antibody against S‐100 protein in 121 cases of gastric cancer. Infiltration of S‐100 protein‐positive DCs was evaluated in the primary tumor and in the peritumoral, primary, secondary, and tertiary nodes. Results. The extent of infiltration by DCs into the regional lymph nodes decreased significantly with an increasing distance of the nodes from the primary tumor. Correlation of the extent of such infiltration was observed among the peritumoral, primary, secondary, and tertiary nodes. However, the extent of infiltration into the primary tumor did not correlate with that into the primary, secondary, and tertiary nodes. Infiltration by DCs of the peritumoral nodes correlated with that of the tumor, particularly when lymph node metastasis was absent. There was no significant difference in the extent of infiltration into the peritumoral nodes even when lymph nodes were involved. However, infiltration of DCs increased in the primary and secondary nodes when the primary nodes were involved. Conclusion. Infiltration of DCs may be regulated in the primary lesion of gastric cancer. The peritumoral lymph nodes serve as transmitters of DCs from the primary tumor to the regional lymph nodes. DCs in the regional lymph nodes are important for establishing immunologic defense mechanisms in cases of gastric cancer when metastasis is absent or limited to the primary nodes. Cancer 1995;75:1478‐83.