Early gastric cancer: a clinicopathologic study

We report our experience, between 1973 and 1989 of 302 patients with gastric cancer in a Dutch general hospital. In 144 (47.7%) of them gastric resection was performed. Twenty-eight patients had early gastric cancer (EGC) (9.3% of the entire series and 19.4% of the resected specimens). Multicentricity of EGC was noted in 3 patients (10.7%). The incidence of EGC decreased slightly during consecutive 8-year intervals. There were 16 men and 12 women (mean age 64 and 66 years, respectively). Standard biphasic contrast radiographic studies of the upper gastrointestinal tract diagnosed or suggested malignancy in all but one patient. Endoscopy with directed biopsy diagnosed malignancy in all patients. Twenty-one lesions (67.7%) were localized to the antral region. Type IIc was most frequent (38.7%). There were 21 intestinal-type and 10 diffuse-type EGC by the Lauren classification. The incidence of intestinal-type EGC decreased during two consecutive 8-year periods. All type I and IIa lesions were of the intestinal type, whereas all diffuse-type EGCs were either type IIc or III. Lymph node metastasis was observed in 9.7% of the lesions. The incidence of lymph node metastasis increased from 0% in mucosal cancer to 20% in submucosal cancer. The overall 5-year survival rate was 91.3%: (diffuse type 100% and intestinal type 85.7%). The 5-year survival rate was 100% in mucosal cancer and 81.8% in submucosal cancer.