title: Choice of the surgical treatment in early gastric cancer.
abstract: OBJECTIVE
  The authors report their experience in choosing the surgical treatment for early gastric cancer.
  
  
  METHODS
  A retrospective study was conducted to examine the long-term outcome of 18 patients with early gastric cancer (10%) on a series of 180 patients treated for gastric carcinoma by the same surgical équipe from January 1986 to June 1997. Radical surgery with gastrectomy and extended lymphadenectomy ("regional" from 1986 to 1991; D2 from 1992 to 1997) was chosen as standard treatment for early gastric cancer except in elderly or high-risk patients and in cases of mucosal tumors diagnosed at definitive histology after surgery for benign diseases in which limited surgery was performed.
  
  
  RESULTS
  All patients received curative (R0) surgery. One patient with mucosal-N1 tumor and another one with submucosal-N0 tumor died because of gastric cancer at 51 and 42 postoperative months respectively. The mean follow-up time was 99.8 (11-193) months. The overall 5-year and 10-year survival rates are 86.7% and 86.7% respectively. The 5- and 10-year survival rates for intramucosal tumors are 91% and 91% respectively and for submucosal cancer are 75% and 75% (P=0.39).
  
  
  CONCLUSIONS
  According to the prognostic value of nodal involvement and the difficulty in achieving a preoperative accurate diagnosis of depth of invasion and of nodal involvement in early gastric cancer, a radical gastric resection with D2-lymphadenectomy should be performed.
authors.affiliation: Department of Surgical Sciences La Sapienza University, Rome, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Custureri
authors.forename: Valerio
authors.initials: V
authors.lastname: D'Orazi
authors.forename: Nadia
authors.initials: N
authors.lastname: Peparini
authors.forename: Riccardo
authors.initials: R
authors.lastname: Gabatel
authors.forename: Paolo
authors.initials: P
authors.lastname: Urciuoli
authors.forename: Gregorio
authors.initials: G
authors.lastname: Patrizi
authors.forename: Adriano
authors.initials: A
authors.lastname: Redler
authors.forename: Giorgio
authors.initials: G
authors.lastname: Di Matteo
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D005753:Gastric Mucosa / Q000473:pathology; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome