Clinicopathological features of early gastric cancer: results of 100 cases from a rural general hospital.
OBJECTIVE
To evaluate 100 patients with early gastric cancer from the point of view of early detection, clinicopathological variables, and long term results.


METHODS
Retrospective study.


METHODS
Rural general hospital, Japan.


METHODS
100 patients with early gastric cancer (confined to the epithelium, lamina propria, or submucosa) out of a total of 197 who had gastric cancers resected for cure between May 1986 and April 1996.


METHODS
Subtotal gastrectomy (n = 87), total gastrectomy (n = 8), proximal gastrectomy (n = 2), and local wedge resection (n = 3).


METHODS
Histopathological features and outcome.


RESULTS
The mean annual incidence of early gastric cancer was 51% (range 35%-70%). 16/59 patients with mucosal cancer (37%) and 18/41 with submucosal cancer (44%) presented with symptoms of the disease. The diagnosis was made in 62 by endoscopy, and in only 2 by upper gastrointestinal radiographic examination. None of the 59 with mucosal cancer had lymphatic invasion, and only 1 had a lymph node metastasis. Among the 41 with submucosal cancer, however, 15 had lymphatic invasion (37%), 13 had venous invasion (32%), and 2 had lymph node metastases (5%). 83 patients were alive with no sign of recurrence at the time of writing (median follow up 62 months, range 12-136). One patient with a tumour that produced alpha-fetoprotein died of hepatic metastases 23 months after subtotal gastrectomy. 9 patients developed second cancers, and 6 died of these with no signs of recurrence of early gastric cancer. The overall 5 and 10 year survival rates were 82% and 66%, and the corresponding disease-specific survival rates for 85 patients were both 98%.


CONCLUSIONS
Excellent long term results can be achieved in the treatment of early gastric cancer, even in a non-specialist centre. Patients with early gastric cancer should have their alpha-fetoprotein concentration measured, and be examined for the presence of other malignant disease both before and after treatment of the gastric cancer.
Tachibana
M
M
Department of Surgery, Masuda Medical Association Hospital, Japan.
Takemoto
Y
Y
Monden
N
N
Nakashima
Y
Y
Kinugasa
S
S
Dhar
D K
DK
Kotoh
T
T
Kubota
H
H
Kohno
H
H
Nagasue
N
N
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D005260:Female; D005743:Gastrectomy; D006780:Hospitals, Rural / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D016609:Neoplasms, Second Primary / Q000401:mortality; D013270:Stomach / Q000473:pathology*; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome