title: Radical endoscopic resection is unsuitable for most synchronous, multiple and early gastric cancers.
abstract: OBJECTIVE
  It remains unclear whether synchronous, multiple, early gastric cancers can be radically resected with endoscopic resection.
  
  
  METHODS
  Patients who underwent gastrectomy for early gastric cancer were included in this study and divided into two groups: a solitary gastric cancer group and a multiple gastric cancer group. The clinicopathological features of patients in each group were compared and the criteria for endoscopic resection were subsequently investigated.
  
  
  RESULTS
  A total of 244 patients were included in the present study. The solitary and multiple gastric cancer groups included 228 patients (93.4%) and 16 patients (6.6%), respectively. The multiple gastric cancer group included 35 lesions, including a greater number of larger tumors and protruded- type tumors, as well as increased incidence of submucosal and lymphatic invasion. Only 2 of 16 cases (12.5%) in the multiple gastric cancer group met the criteria for endoscopic resection. Eleven cases were excluded due to submucosal invasion and three cases were excluded due to undifferentiated histopathological type tumors.
  
  
  CONCLUSIONS
  To be suitable for radical endoscopic resection, prompt detection of early gastric cancer is essential, before they become multiple gastric cancers and invade the submucosa.
authors.affiliation: Department of Gastrointestinal Surgery, Oita University Hospital, Oita, Japan. fshodroi@yahoo.co.jp
authors.forename: Shozo
authors.initials: S
authors.lastname: Fujiwara
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Noguchi
authors.forename: Takuya
authors.initials: T
authors.lastname: Noguchi
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Aizawa
authors.forename: Mototsugu
authors.initials: M
authors.lastname: Matsunaga
authors.forename: Hatsuo
authors.initials: H
authors.lastname: Moriyama
mesh_terms: D000368:Aged; D002454:Cell Differentiation; D055088:Early Detection of Cancer; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005743:Gastrectomy; D005753:Gastric Mucosa / Q000473:pathology / Q000601:surgery; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009378:Neoplasms, Multiple Primary / Q000473:pathology / Q000601:surgery*; D018579:Patient Selection; D011237:Predictive Value of Tests; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome