SURGICAL TREATMENT AND PROGNOSIS OF EARLY GASTRIC CANCER
SERDAR YOL1, TAKAO SUZUKI2, TAKENORİ OCHIAI2, YOSHİO GUNJI2, KAİCHİ ISONO2
1Selçuk Üniversitesi Tıp Fakültesi Genel Cerrahi Anabilim Dalı, KONYA
2Chiba Üniversitesi, Tıp Fakültesi, 2. Cerrahi Kliniği, Chiba, JAPONYA
Abstract
The aim of this study is to investigate the clinical and histopathological features of early gastric cancer with special emphasis on survival after surgical treatment and prognostic factors. Two hundred and seventy four cases with early gastric cancer, who were operated on between 1984 and 1994 in the Second Department of Surgery, Chiba University, were included in this study. The ratio of male/female was 2.75, the mean age was 61.3 years. The lesion were located in the corpus in 50% of the patients, and 53% of the iesions were type IIc. Distal subtotal gastrectomy was performed in 219 patients (80%) and total gastrectomy in 47 patients (17.1%) all with a D2 lymph node dissection. Cancer was located in only mucosa in 52.6%, well-differentiated in 42% and multifocal in 10.2% of patients. Lymph node involvement was present in 2.1% of patients in mucosal cancers whereas 16.2% in submucosal invading cancers (p=0.0001). Deaths related to cancer were seen in only 10 patients. The 5 and 10 year actuarial survival rates were 92.3% and 82.8%, respectively. The survival rate was significantly higher for mucosal cancers than for submucosal cancers(p=0.041). But survival showed no significant correlation with lymph node involvement, tumor size and differentiation.
Keywords: EARLY GASTRIC CANCER, D2 LYMPH NODE DISSECTION, PROGNOSIS