Significance of Follow-up Studies on the Residual Stomach after Operation for Early Gastric Cancer from the Analysis of Multipla Early Gastric Cancer

The significance of follow-up studies on the stomach remnant after operation for early gastric cancer was examined in this study. Eighty-three cases with synchronous multiple early gastric cancers were treated sur-gically at our center between 1987 and 1998, and during the same period, 11 of these cases with early gastric cancer who had undergone gastrectomy were diagnosed by postoperative follow-up study as having gastric cancer in the stomach remnant. A large proportion of the initial and 2nd lesions of multiple gastric cancers, 85.5%and 94.4%, respectively, was classified as being the differentiated type of adenocarcinoma. A large pro-portion of the cases (71.1%) as diagnosed by postoperative histopathological examination as having multiple gastric cancers, and the accuracy of preoperatively diagnosing the presence of multiple lesions was as low as 28.9%. The mean period from the operation for the initial gastric cancer to the diagnosis of gastric cancer in the stomach remnant in the 11 cases was 48 months; the diagnosis in all the cases was established in less than 10 years, implying that the possibility that the lesions diagnosed at follow-up were already present at the time of the first surgery cannot be denied. Thus, it is considered that detalied follow-up studies of the stomach remnant is necessary after operation for early gastric cancer, especially in cases with differentiated type of adenocarcinoma, to rule out the possible presence of an accessory lesion.