In order to investigate the
hormone dependency of
gastric cancer, the presence of
estrogen receptor (E.R.) in surgically resected carcinomatous tissues was studied. E.R. assay was performed by
dextran coated
charcoal method. We have found 10% E.R. positive cases in
gastric cancer (4/40). These 4 patients were all female, and showed Borrmann 3 or 4 type macroscopically. The histological types of these cases were
signet-ring cell carcinoma or poorly differentiated
adenocarcinoma. Furthermore, experimental studies suggest that the growth of
signet-ring cell carcinoma transplanted on nude mice depends on
sex hormone. Based on these observations, the clinical trial of chemo-endocrine
therapy after
gastrectomy for female patients with diffuse
carcinoma of the stomach has been performed in our hospital since 1980. The
therapy consists of
Mitomycin-C plus subsequent
Tegafur, with or without
Tamoxifen 20 mg/day given orally, twice a day starting 2 weeks after surgery. The results are as follows: The cumulative 3-year survival rate in 21 cases receiving chemo-endocrine
therapy (TAM+) after
gastrectomy revealed higher (43.3%) than that (5.6%) in 23 cases receiving
chemotherapy alone (TAM-). Furthermore, 2 and 3 years survival rates of TAM + in curatively resected cases (8 cases) were both 100% including 2 recurrent cases. In TAM- 10 cases, 2 and 3 years survival rate showed 68.4% and 16.3% respectively with statistically significance (p less than 0.01). Chemo-endocrine
therapy for non-curatively resected and recurrent cases were also effective. This result suggests that the chemo-endocrine
therapy after
gastrectomy may be a new hopeful adjuvant in female patients with diffuse
carcinoma of the stomach.