Cancer of the stomach: A review of two hospitals in Korea and Japan

The records of 525 patients with primary adenocarcinoma of the stomach treated at Korea University Hospital (K.U.H.), Seoul, Korea, and 1,932 patients treated at National Cancer Center Hospital (N.C.C.), Tokyo, Japan, over a 7-year period were reviewed to study biologic characteristics and treatment results in the two hospitals. More than 70% of the patients were 41 to 70 years old in both hospitals, though K.U.H. had more younger patients and N.C.C. had more older patients. Comparison in regard to clinicopathologic features showed significant differences in type of cancer, tumor size, depth of invasion, lymph node metastasis, stage, and histologic type. Such a difference mostly was due to a greater frequency of early gastric cancer in N.C.C. patients (51.2%) than in K.U.H. patients (19.0%). Patients of K.U.H. were more likely to have advanced cancer, large invasive tumors, a higher percentage of lymph node metastasis, a higher stage, and more undifferentiated tumors. The 5-year survival rate of all resected cases was 69.5% in N.C.C. and 54.2% in K.U.H. (p>0.05). Those factors which showed a significant difference in clinicopathologic features did not affect the survival difference between the two hospitals except in stage IIIb and signet-ring-cell cancer. The 5-year survival rate for stage IIIb was 18.0% in K.U.H. and 36.8% in N.C.C. It would seem that survival difference in stage IIIb related to extensive lymph node dissection in N.C.C. Survival difference in signetring-cell gastric cancer (31.2% in K.U.H. and 91.0% in N.C.C.) was related to the fact that 79.1% of signet-ring-cell gastric cancer patients in N.C.C. had early gastric cancer. This present study once again demonstrates the importance of early detection in the treatment of gastric cancer and suggests that gastric cancer of two countries is not different.