Prolonged survival of gastric cancer patients on a specific adjuvant chemotherapy.

Since 1970, there has been a remarkable improvement in Japan in the outcome of surgery for patients with gastric cancer. Not only the increased rate of detection of early gastric cancer but the standardization of the prophylactic extended lymphadenectomy (ELX) has brought about a remarkable rise in survival rate. In patients with regional lymph node metastasis, we obtained a 5 year survival rate of 39 percent in the ELX group, whereas the rate was only 18 percent in the simple gastrectomy group. The difference was statistically significant (P less than 0.001). As to adjuvant chemotherapy, the Cooperative Study Group of Surgical Adjuvant Chemotherapy for Gastric Cancer found in data on 1,805 patients followed for 5 years that the protocol, intraoperative bolus intravenous injection of Mitomycin C (MMC) plus oral administration of Futraful (Tegafur) for 3 months, concomitantly applied with ELX, proved to be effective for improving the survival of patients with advanced cancer such as stage III and positive lymph node metastasis with obvious serosal invasion. The 5 year survival rate of Japanese patients with gastric cancer after resective surgery was an overall 56 percent, 48 percent when confined to those with stage III cancer.