Prognosis of patients with gastric cancer and pyloric stenosis: histological differentiation.

The clinicopathology of gastric cancer with pyloric stenosis was examined with special reference to histological differentiation. One hundred sixteen patients treated in Department of Surgery II, Kyushu University Hospital, were classified into differentiated (DT: n = 47) and undifferentiated types (UT: n = 69). The UT group was significantly younger than the DT group (P < 0.05). There were no differences in the incidence of serosal invasion, liver metastasis, lymph node metastasis, and the clinical stage between the groups. The incidence of peritoneal dissemination of the UT group was 41% (28/69), a value significantly higher than the 23% (11/47) for the DT group (P < 0.05). The 5-year survival rates of the DT and UT groups were 27% and 16%, respectively, with survival time for the UT group being significantly less than that of the DT group (P < 0.05). In patients with pyloric stenosis and an undifferentiated adenocarcinoma with the risk of peritoneal dissemination, intensive adjuvant chemotherapy seems essential to improve the prognosis.