[Early stomach cancer in comparison with advanced stomach cancer. Results of a prospective study of diagnosis and 5-year survival of 131 patients with early stomach cancer and 795 patients with advanced stomach cancer].
A multicentre prospective observational study with 22 surgical and 14 pathological units in West-Germany gathered data from 1420 patients with gastric cancer between April 1982 and October 1989, 131 patients with early gastric cancer (EGC) and 795 patients with a resectable advanced gastric cancer (AGC) were selected for comparison. Patients with EGC were younger than those with AGC (49% vs 37% younger than 60 years) and symptoms of an ulcer were found twice in comparison to AGC (40.7% vs 23.7%). EGC in comparison to AGC were frequently multifocal (9.2% vs 3.0%) and located in the middle and lower part of the stomach (83.9% vs 56.8%). Five-year-survival rates of mucosa carcinoma was 84% and of submucosal carcinoma 69% (p = 0.0741). WHO-typing of EGC and AGC were identical. But according to Laurén's classification there were more intestinal types with EGC than with AGC (60.3% vs 51.5%) and less diffuse or mixed types with EGC than with AGC (33.6% vs 44.0%). Five-year-survival rates of diffuse and intestinal types of EGC showed no significant difference (p = 0.19). Extended lymph node dissection was done in only one third of EGC and AGC. Five-year-survival rates of 36 EGC patients with and 95 EGC patients without extended lymph node dissection were 85% versus 72% (p = 0.0916). These results are a hint that systematic lymphadenectomy may have a beneficial effect on survival.
Rohde
H
H
Chirurgische Klinik Il, Städtisches Krankenhaus Köln-Merheim der Universität, Bundesrepublik Deutschland.
Stützer
H
H
Bauer
P
P
Heitmann
K
K
Gebbensleben
B
B
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000401:mortality* / Q000473:pathology; D011230:Precancerous Conditions / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*
Das Magenfrühkarzinom im Vergleich zum fortgeschrittenen Magenkarzinom. Ergebnisse einer prospektiven Studie zur Diagnostik und Fünfjahresüberleben von 131 Patienten mit Magenfrühkarzinom (EGC) und 795 Patienten mit fortgeschrittenem Magenkarzinom (AGC). Deutsche Magenkarzinom-TNM-Validierungs-Studiengruppe.