A Critical Analysis of 30 Cases of Early Gastric Cancer

A total of thirty cases of early gastric cancer has been treated in the Surgical Department during the seven year period from 1962 through 1968. That is 11.8 per cent of the resected gastric cancer (254 cases) and 3.8% of all gastric resections (799 cases). Age of the patients ranged from 20 to 70. Male patient predominated over female in a ratio of 2 to 1 (21 to 9). All the female patients were in the younger age group. The breakdown according to the types of the lesion was as follows: Protruding or superficial protruding type 6 Concaving or superficial concaving type 21 Superficial protruding with concaving or superficial concaving type 3 Site of lesion: C (proximal one-third) 0 M (middle one-third) 21 A (distal one-third) 9 Depth of invasion: Infiltration limited to mucous membrane 20 Infiltration invading submucosa 10 Lymph node metastasis: Positive in Group-I nodes in 3 cases. Follow-up: All 30 patients are on follow-up study up to Aug. 1, 1969. Six patients who had operation five or more years ago are alive so that it makes five-year survival 100 per cent. Of the remaining 24, four died of causes other than cancer, one died of the operation itself on 5th post-operative day. Another patient died of unknown cause, therefore classified as dying of cancer according to the General Rules for the Gastric Cancer Study in Surgery and Pathology edited by Japanese Research Society for Gastric Cancer. The type or site of the lesion or depth of invasion seemed not to make any difference. One of these patients survived over 5 years despite lymph node metastasis confirmed microscopically. Because of the nature of the disease and its prevalence in older age group, the critical study of those patients who develop recurrence of the malignancy deserves as much or even more consideration as the five-year survival rate.