Multiple gastric cancers in the aged with special reference to intramucosal cancers

A histopathologic study was made on 512 specimens of gastric cancer that were surgically obtained from aged patients (mean age 73 years) in the Tokyo Metropolitan Geriatric Hospital. Of the 512 cases studied, 408 were gastric cancer of the glandular type (80%) and 104 were of the nonglandular type (20%). There were 75 cases of gastric cancer consisting of multiple independent cancer lesions and 71 of these were histologically diagnosed as multiple (2-5) gastric cancers composed of glandular type only. Of these 71 cases, 21 cases were multiple intramucosal cancers. These 21 cases of multiple intramucosal cancers were compared with 49 cases of single intramucosal cancers of glandular type in terms of the maximum diameter of each lesion and the location within the stomach. The results suggest that, in aged patients, there is a great possibility that collision of multiple cancer lesions may result in a single intramucosal gastric cancer measuring over 3 cm in diameter.