Relation between early and advanced gastric cancer

Of 75 consecutive inpatients with gastric carcinoma during a 3.5 year period, 40 underwent operation with the intention of cure, 5 had palliative gastric resection and 30 had exploratory celiotomy only. Early gastric cancer was found in 11 cases, that is, 15 percent of patients with gastric carcinoma or 24 percent of patients subjected to gastrectomy. The patients with early gastric cancer were operated on with the intention of cure. Comparison with a previous series from the same geographic area shows that the ratio between early gastric cancer and all gastric cancer increased significantly. This improvement in the management of patients with gastric carcinoma can be ascribed to the use of gastroscopy and biopsy. The survival rates in patients with early gastric cancer are excellent. The prognosis in patients with advanced gastric cancer, on the other hand, is poor and has remained so for the last 30 to 40 years. Twelve of the 75 patients had gastric stump carcinoma; 2 of these were early gastric cancer. Screening of asymptomatic patients for gastric cancer is at present an impossible task in most Western countries, but the risk of cancer after partial gastrectomy for benign lesions makes screening desirable in this selected group of patients.