[Malignant degeneration of stomach ulcer]

It is a follow up of 242 patients with gastric ulcer disease. Sixty two per cent of them were observed for more than 3 years. They were controlled by X-ray examinations (41%) or endoscopically (59%). Full recovery was obtained in 127 patients (53%). A total of 115 were not healed until the end of the survey. The risk of malignisation is estimated as very low. Only 5 patients developed cancer of the stomach (2,06%). Much more important is the early differential diagnosis between gastric ulcer and the primary ulcerative form of gastric cancer. The follow up care of a gastric ulcer disease should be effectuated not by X-ray but by gastrofibroscopic examinations in individual terms and aimed biopsies should be taken as much as possible. Operation is rejected as standard policy in gastric ulcers that were not healed after 3-month medical treatment. It seems advisable to avoid gastroduodenal resection (Billroth II) for gastric ulcer, as a remote prophylaxis against primary cancer of the gastric stump.