[Long term survival of patients operated for early gastric cancer].
BACKGROUND
Early gastric cancer involves mucosa and submucosa, independent of lymph node involvement. Radical gastrectomy is the standard treatment.


OBJECTIVE
To assess long term survival of patients operated for an early gastric cancer.


METHODS
Retrospective review of medical and pathology records of patients subjected to a gastrectomy for an early gastric cancer, between 1975 and 2002. All were treated using a standardized protocol and staged according to 2002 TNM classification of the American Joint Committee of Cancer (AJCC). Demographic and pathologic features, operation performed and long term survival were recorded. Survival was analyzed using Kaplan-Meier method.


RESULTS
The series is comprised by 64 males and 41 females aged 61 +/- 1 years. Tumor was located in the upper third of the stomach on 33 subjects and a total gastrectomy was performed in 53. Pathology showed an intestinal type adenocarcinoma in 82 and a diffuse type in 23. In patients with involvement of mucosa and submucosa, 24 +/- 14 and 22 +/- 14 lymph nodes were excised, respectively. Lymph node involvement was present in 8% and 22% of patients with involvement of mucosa and submucosa, respectively. Five years survival was 94% and 78% in patients without and with lymph node involvement, respectively. Survival among patients in stage IA and IB was 94% and 76%, respectively. Multivariate analysis showed that the lymph node involvement was an independent mortality risk factor.


CONCLUSIONS
Total gastrectomy in patients with early gastric cancer is associated with a good survival. Lymph node involvement is a mortality risk factor.
Butte
Jean M
JM
Departamento de Cirugía Digestiva, Pontificia Universidad Católica de Chile, Santiago, Chile.
Torres
Javiera
J
Viviani
Paola
P
Duarte
Ignacio
I
Crovari
Fernando
F
Guzmán
Sergio
S
Cabrera
Roberto
R
Pedemonte
Juan
J
Llanos
Osvaldo
O
D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D005260:Female; D005743:Gastrectomy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D017741:Survivors