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Recurrence in early gastric cancer
Y Ichiyoshi1, T Toda, Y Minamisono
1Institute of Gastroenterology of Hofu, Yamaguchi, Japan.
Surgery
|May 1, 1990
Summary
Early gastric cancer recurrence is linked to specific risk factors. Submucosal cancers with elevated appearance, lymph node metastasis, and vessel invasion risk hematogenic recurrence, necessitating adjuvant chemotherapy.
Area of Science:
- Gastroenterology
- Oncology
- Surgical Oncology
Background:
- Early gastric cancer (EGC) management requires understanding recurrence patterns.
- Mortality in EGC patients can stem from cancer recurrence or unrelated causes.
Purpose of the Study:
- To analyze recurrence patterns and mortality rates in early gastric cancer.
- To identify high-risk factors for recurrence and inform treatment strategies.
Main Methods:
- Retrospective analysis of 503 early gastric cancer cases.
- Evaluation of recurrence sites, including hematogenic metastasis, lymph nodes, and residual stomach.
Main Results:
- Cumulative recurrence mortality rates were 2.2% at 9 years (mucosal) and 8.4% at 8 years (submucosal).
- Hematogenic recurrence occurred in 9 cases (liver, lung, bone); lymph node recurrence in 3; residual stomach recurrence in 5.
- High-risk factors for hematogenic recurrence included submucosal tumors with elevated appearance, lymph node metastasis, and vessel invasion.
Conclusions:
- Adjuvant chemotherapy is recommended for high-risk submucosal EGC.
- Complete lymph node dissection is crucial, irrespective of macroscopic nodal status, due to potential metastasis to group 2 nodes.
- Regular postoperative follow-up is essential for detecting recurrences in the residual stomach, often due to missed multiple lesions.