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Early gastric cancer.

D R Farley1, J H Donohue, D M Nagorney

  • 1Department of Surgery, Mayo Clinic, Rochester, Minnesota 55905.

The British Journal of Surgery
|June 1, 1992
PubMed
Summary

Early gastric cancer (EGC) is rare in Western countries. This study found that a good Eastern Cooperative Oncology Group score and diploid DNA pattern significantly predict survival in EGC patients.

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Oncology

Background:

  • Early gastric cancer (EGC) is prevalent in Japan but uncommon in Western regions.
  • EGC diagnosis and management present unique challenges in Western healthcare settings.

Purpose of the Study:

  • To review the surgical management and outcomes of early gastric cancer patients.
  • To identify prognostic factors influencing survival in early gastric cancer.

Main Methods:

  • Retrospective review of 48 patients with EGC treated between 1965 and 1984.
  • Analysis of preoperative diagnostic methods (oesophagogastroduodenoscopy with biopsy, upper gastrointestinal radiography).
  • Evaluation of surgical procedures (subtotal gastrectomy, total gastrectomy, wide local excision) and patient survival data.

Main Results:

  • Oesophagogastroduodenoscopy with biopsy had an 88% diagnostic rate, while radiography had only 20%.
  • Subtotal gastrectomy was the predominant surgical approach (86%).
  • Operative mortality was 0%, with a 38% morbidity rate. Mean follow-up was 7.7 years, with 44% survival.
  • Multivariate analysis identified Eastern Cooperative Oncology Group (ECOG) score (P=0.002) and diploid DNA (P=0.05) as significant prognostic factors.

Conclusions:

  • Early gastric cancer survival rates are comparable to the general population when prognostic factors are favorable.
  • Diagnostic yield varies significantly between endoscopic biopsy and radiographic imaging.
  • Surgical management of EGC can achieve favorable outcomes with low operative mortality.

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