Skip to main content
PMC home page
British Medical Journal (Clinical Research Ed.) logoLink to British Medical Journal (Clinical Research Ed.)
. 1985 Aug 3;291(6491):305–308. doi: 10.1136/bmj.291.6491.305

Early gastric cancer: the case for long term surveillance.

P W Houghton, N J Mortensen, A Allan, R C Williamson, J D Davies
PMCID: PMC1416609  PMID: 3926168

Abstract

Thirty five patients with early gastric cancer have been treated at the Bristol Royal Infirmary since 1965. The number of cases diagnosed has doubled in the last 10 years. Epigastric pain (74%), loss of weight (63%), and gastrointestinal bleeding (43%) were the most common presenting symptoms, with a median length of history of 12 months (range five days to 72 months). Life table survival curves showed a crude five year survival of 71% (age adjusted 92%) and a crude 10 year survival of 63% (age adjusted 85%). Sixteen patients have been followed up clinically, endoscopically, and by scintigraphy with technetium-99m p-butyl iminodiacetic acid to assess the risk of recurrent disease. Of seven patients with pronounced bile reflux, two had moderate dysplasia of the gastric remnant, and one patient was found to have developed a metachronous tumour nine years after surgery. Partial resection seems to be the best choice of treatment for early gastric cancer, giving good functional results. Consideration should, however, be given to Roux en Y diversion, and long term surveillance of the gastric remnant is recommended.

Full text

PDF
308

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Carter K. J., Schaffer H. A., Ritchie W. P., Jr Early gastric cancer. Ann Surg. 1984 May;199(5):604–609. doi: 10.1097/00000658-198405000-00016. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Davies J. D., Tudway A. J., Roberts G., Machado G. Detection of superficial gastric carcinoma in biopsies and resected stomachs. J Clin Pathol. 1976 Aug;29(8):756–757. doi: 10.1136/jcp.29.8.756. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Domellöf L., Janunger K. G. The risk for gastric carcinoma after partial gastrectomy. Am J Surg. 1977 Nov;134(5):581–584. doi: 10.1016/0002-9610(77)90439-1. [DOI] [PubMed] [Google Scholar]
  4. Evans D. M., Craven J. L., Murphy F., Cleary B. K. Comparison of "early gastric cancer" in Britain and Japan. Gut. 1978 Jan;19(1):1–9. doi: 10.1136/gut.19.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Farrands P. A., Blake J. R., Ansell I. D., Cotton R. E., Hardcastle J. D. Endoscopic review of patients who have had gastric surgery. Br Med J (Clin Res Ed) 1983 Mar 5;286(6367):755–758. doi: 10.1136/bmj.286.6367.755. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Fevre D. I., Green P. H., Barratt P. J., Nagy G. S. Review of five cases of early gastric carcinoma. Gut. 1976 Jan;17(1):41–47. doi: 10.1136/gut.17.1.41. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. 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]
  8. 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]
  9. Kaneko E., Nakamura T., Umeda N., Fujino M., Niwa H. Outcome of gastric carcinoma detected by gastric mass survey in Japan. Gut. 1977 Aug;18(8):626–630. doi: 10.1136/gut.18.8.626. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Kobayashi S., Kasugai T. Brushing cytology for the diagnosis of gastric cancer involving the cardia or the lower esophagus. Acta Cytol. 1978 May-Jun;22(3):155–157. [PubMed] [Google Scholar]
  11. Koga S., Kaibara N., Tamura H., Nishidoi H., Kimura O. Cause of late postoperative death in patients with early gastric cancer with special reference to recurrence and the incidence of metachronous primary cancer in other organs. Surgery. 1984 Sep;96(3):511–516. [PubMed] [Google Scholar]
  12. Morson B. C., Sobin L. H., Grundmann E., Johansen A., Nagayo T., Serck-Hanssen A. Precancerous conditions and epithelial dysplasia in the stomach. J Clin Pathol. 1980 Aug;33(8):711–721. doi: 10.1136/jcp.33.8.711. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Mortensen N. J., Mackenzie E. F. Accuracy of oesophageal brush cytology: results of a prospective study and multicentre slide exchange. Br J Surg. 1981 Jul;68(7):513–515. doi: 10.1002/bjs.1800680723. [DOI] [PubMed] [Google Scholar]
  14. Mortensen N. J., Thomas W. E., Jones S. M., Savage A. Endoscopic screening for premalignant changes 25 years after gastrectomy: results of a five-year prospective study. Br J Surg. 1984 May;71(5):363–367. doi: 10.1002/bjs.1800710519. [DOI] [PubMed] [Google Scholar]
  15. Murakami T. Early cancer of the stomach. World J Surg. 1979 Nov;3(6):685–692. doi: 10.1007/BF01654788. [DOI] [PubMed] [Google Scholar]
  16. Rösch W., Frühmorgen P. Endoscopic treatment of precanceroses and early gastric carcinoma. Endoscopy. 1980 May;12(3):109–113. doi: 10.1055/s-2007-1021723. [DOI] [PubMed] [Google Scholar]
  17. Schrumpf E., Serck-Hanssen A., Stadaas J., Aune S., Myren J., Osnes M. Mucosal changes in the gastric stump 20-25 years after partial gastrectomy. Lancet. 1977 Sep 3;2(8036):467–469. doi: 10.1016/s0140-6736(77)91599-9. [DOI] [PubMed] [Google Scholar]
  18. Tatsuta M., Iishi H., Okuda S., Taniguchi H. Diagnosis of early gastric cancers in the upper part of the stomach by the endoscopic Congo red-methylene blue test. Endoscopy. 1984 Jul;16(4):131–134. doi: 10.1055/s-2007-1018556. [DOI] [PubMed] [Google Scholar]
  19. Thomas W. E., Cooper M. J., Mortensen N. J., Burton P. A., Davies E. R. The clinical assessment of duodenogastric reflux by scintigraphy and its relation to histological changes in gastric mucosa. Scand J Gastroenterol Suppl. 1984;92:195–199. [PubMed] [Google Scholar]
  20. Tsukuma H., Mishima T., Oshima A. Prospective study of "early" gastric cancer. Int J Cancer. 1983 Apr 15;31(4):421–426. doi: 10.1002/ijc.2910310405. [DOI] [PubMed] [Google Scholar]

Articles from British Medical Journal (Clinical research ed.) are provided here courtesy of BMJ Publishing Group

RESOURCES