Factors influencing the postoperative course 113 patients with early gastric cancer

One hundred and thirteen patients with early gastric cancer operated on during the period from 1967 to 1982 were followed up until 1985; 24 of them died. The 5- and 10-year cumulative survival rates of 99 patients, excluding 14 (12.4%) who died of diseases unrelated to gastric cancer, were 97.8% and 89.1%, respectively. Of the 24 deaths, seven were due to recurrence of gastric cancer, one to pulmonary metastasis found preoperatively and 16 to diseases unrelated to gastric cancer. Recurrence took the form hepatic metastasis in four cases, bone metastasis in two and recurrence in the gastric remnant in one. The metastases were distant in the majority of cases of recurrence, and recurrence characteristically occurred late, with six patients dying more than 5 years and one dying 10 years after surgery. The recurrences were mostly found in patients with poorly differentiated adenocarcinoma. On the other hand, the causes of death in 16 patients were diseases unrelated to gastric cancer, i.e., primary cancer of other organs in six, operative complications, heart diseases, senility, and pneumonia in two each, and a traffic accident and apoplexy in one each. Thus, Many of the deaths were due to primary cancer of other organs. Four patients underwent non-curative resection. One had lung metastasis found preoperatively and the remaining three had positive margins. The latter three did not undergo a second operation, but the causes of their deaths were not recurrence of gastric cancer. It is necessary to follow up patients from the standpoint not only of recurrence of gastric cancer, but also of diseases other than gastric cancer and multiple gastric cancer in elderly patients.