Abstract
A retrospective study of early gastric cancer (60 patients) was performed to evaluate its diagnosis and treatment. Ninety-five per cent of patients presented with nonspecific gastrointestinal symptoms and 53.3% had been treated for presumed benign disease for up to 48 months before diagnosis. Fiberoptic endoscopy detected these lesions more accurately than radiologic examination. The disease-free 5-year survival rate after resection was 76.4%. Survival showed no significant correlation with sex, tumor site, macroscopic appearance, extent of gastric resection, or histopathologic type. Tumors larger than 1.5 cm in diameter, invasion of submucosa, or lymph node metastasis resulted in significantly lower survival rates. Three of eight patients with nodal metastasis survived 5 or more years, including one who had second-echelon deposits. A high index of suspicion may permit more frequent detection. Extended lymphadenectomy (R2) is recommended to achieve the highest possible cure rate.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bringaze W. L., 3rd, Chappuis C. W., Correa P., Cohn I., Jr Early gastric cancer. 21-year experience. Ann Surg. 1986 Aug;204(2):103–107. doi: 10.1097/00000658-198608000-00001. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fielding J. W., Ellis D. J., Jones B. G., Paterson J., Powell D. J., Waterhouse J. A., Brookes V. S. Natural history of "early" gastric cancer: results of a 10-year regional survey. Br Med J. 1980 Oct 11;281(6246):965–967. doi: 10.1136/bmj.281.6246.965. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fukutomi H., Sakita T. Analysis of early gastric cancer cases collected from major hospitals and institutes in Japan. Jpn J Clin Oncol. 1984 Jun;14(2):169–179. [PubMed] [Google Scholar]
- Gebhardt C., Husemann B., Hermanek P., Gentsch H. H. Clinical aspects and therapy of early gastric cancer. World J Surg. 1981 Sep;5(5):721–724. doi: 10.1007/BF01657936. [DOI] [PubMed] [Google Scholar]
- Green P. H., O'Toole K. M., Weinberg L. M., Goldfarb J. P. Early gastric cancer. Gastroenterology. 1981 Aug;81(2):247–256. [PubMed] [Google Scholar]
- Habu H., Takeshita K., Sunagawa M., Endo M. Lymph node metastasis in early gastric cancer. Int Surg. 1986 Oct-Dec;71(4):244–247. [PubMed] [Google Scholar]
- Iriyama K., Asakawa T., Koike H., Nishiwaki H., Suzuki H. Is extensive lymphadenectomy necessary for surgical treatment of intramucosal carcinoma of the stomach? Arch Surg. 1989 Mar;124(3):309–311. doi: 10.1001/archsurg.1989.01410030059010. [DOI] [PubMed] [Google Scholar]
- Korenaga D., Tsujitani S., Haraguchi M., Okamura T., Tamada R., Sugimachi K., Akazawa K., Nose Y. Long-term survival in Japanese patients with far advanced carcinoma of the stomach. World J Surg. 1988 Apr;12(2):236–240. doi: 10.1007/BF01658063. [DOI] [PubMed] [Google Scholar]
- Korenaga D., Tsujitani S., Haraguchi M., Okamura T., Tamada R., Sugimachi K., Akazawa K., Nose Y. Long-term survival in Japanese patients with far advanced carcinoma of the stomach. World J Surg. 1988 Apr;12(2):236–240. doi: 10.1007/BF01658063. [DOI] [PubMed] [Google Scholar]
- LAUREN P. THE TWO HISTOLOGICAL MAIN TYPES OF GASTRIC CARCINOMA: DIFFUSE AND SO-CALLED INTESTINAL-TYPE CARCINOMA. AN ATTEMPT AT A HISTO-CLINICAL CLASSIFICATION. Acta Pathol Microbiol Scand. 1965;64:31–49. doi: 10.1111/apm.1965.64.1.31. [DOI] [PubMed] [Google Scholar]
- Maruyama K., Okabayashi K., Kinoshita T. Progress in gastric cancer surgery in Japan and its limits of radicality. World J Surg. 1987 Aug;11(4):418–425. doi: 10.1007/BF01655804. [DOI] [PubMed] [Google Scholar]
- McBride C. M., Boddie A. W., Jr Adenocarcinoma of the stomach: are we making any progress? South Med J. 1987 Mar;80(3):283–286. doi: 10.1097/00007611-198703000-00002. [DOI] [PubMed] [Google Scholar]
- Meyers W. C., Damiano R. J., Jr, Rotolo F. S., Postlethwait R. W. Adenocarcinoma of the stomach. Changing patterns over the last 4 decades. Ann Surg. 1987 Jan;205(1):1–8. doi: 10.1097/00000658-198701000-00001. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Noguchi Y., Imada T., Matsumoto A., Coit D. G., Brennan M. F. Radical surgery for gastric cancer. A review of the Japanese experience. Cancer. 1989 Nov 15;64(10):2053–2062. doi: 10.1002/1097-0142(19891115)64:10<2053::aid-cncr2820641014>3.0.co;2-j. [DOI] [PubMed] [Google Scholar]
- Okuda H., Suzuki S., Suzuki H., Kurokawa K., Kitamura Y., Mitsunaga A., Hashimoto H., Obata H. Diagnosis and prognosis of early gastric cancer: the experience in Japan. Trop Gastroenterol. 1988 Jan-Mar;9(1):7–13. [PubMed] [Google Scholar]
- Sakita T., Oguro Y., Takasu S., Fukutomi H., Miwa T. Observations on the healing of ulcerations in early gastric cancer. The life cycle of the malignant ulcer. Gastroenterology. 1971 May;60(5):835–passim. [PubMed] [Google Scholar]