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.

Surgical treatment of microscopic disease in grossly normal para-aortic lymph nodes may generate occasional long-term survivors. Selecting appropriate candidates who might benefit from D4 resections needs to be refined. On the basis of this study, a nationwide study should be considered.

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.

Background. This study evaluated the prognosis of patients with carcinoma in the gastric remnant stump after distal gastrectomy for benign disease (stump cancer). Methods. Twenty patients with resected stump cancer were studied and compared with 266 patients with resected primary cancer in the upper third of the stomach (primary cancer). Results. The percentages of lymph nodes with metastases located at the lesser curvature and the left gastric artery, respectively, were 50.0% and 25.2% in patients with primary cancer and 15.0% and 5.0% in patients with stump cancer. In patients with remnant gastric cancer, lymph node metastases at jejunal mesentery near anastomotic site were found in 2 of 20 (10.0%). Conclusion. The lymph flow from the remnant stomach seems to be changed by the initial operation, and as a result, in stump cancer, metastatic lymph nodes are located at different places from those associated with primary cancer. Even when curative surgery is performed in patients with stump cancer, it is important to follow up patients and check for possible metastasis to the liver. The 5‐year survival rates were 62.1% and 52.5% for patients with curatively resected primary cancer (n = 203) and stump cancer (n = 17), respectively, and there was no statistical difference between the two groups. There was a distinct difference in terms of patterns of recurrence between patients with curatively resected primary cancer and those with stump cancer. The percentages of peritoneal and hematogenic metastases, respectively, were 40.6% and 31.3% in primary cancer and 0% and 83.3% in stump cancers.

We analyzed heating profiles from 318 hyperthermic treatments of 39 patients with recurrent or inoperable cancers of the digestive organs whose deep-seated tumors were treated by radiofrequency (RF) capacitive heating of the abdominal region, and we investigated the heating efficiency and antitumor effect of such treatment. It was apparent that heating with a mean maximum RF output of 1,000 watts (700 watts at least), repeated four times or more, was necessary for a high rate of response by the tumor. Although it was difficult to heat tumors of the bile duct/pancreas to 42 degrees C or more, there was a strong positive correlation between maximum output of RF energy and maximum temperature of tumors (r = 0.839, P less than 0.001). The antitumor effect of RF hyperthermia was augmented with increasing output of RF energy. Therefore, the maximum level of RF output may be a useful index for expressing the heating efficiency with respect to intra-abdominal deep-seated tumors.