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Early gastric cancer.

K J Carter, H A Schaffer, W P Ritchie

    Annals of Surgery
    |May 1, 1984
    PubMed
    Summary
    This summary is machine-generated.

    Early gastric cancer (EGC) is as treatable in the US as in Japan, with a 100% 5-year survival rate. Advanced gastric cancer (ADV) has a 15% 5-year survival rate. Distinguishing EGC from ADV pre-surgery is difficult, necessitating aggressive surgical approaches.

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    Area of Science:

    • Gastroenterology
    • Surgical Oncology
    • Oncology

    Background:

    • Early gastric cancer (EGC) is common in Japan but considered infrequent in the US.
    • A review of gastric cancer resections revealed EGC in 16% of patients, challenging its perceived rarity in the US.

    Purpose of the Study:

    • To compare EGC with advanced gastric cancer (ADV) in the US.
    • To identify pre-operative features distinguishing EGC from ADV.
    • To assess if US survival rates for EGC mirror Japanese outcomes.

    Main Methods:

    • Retrospective review of "curative" resections for gastric cancer (1974-1982).
    • Comparison of EGC (n=5) and ADV (n=26) based on historical, laboratory, radiographic, and endoscopic data.
    • Blind review of radiographs and pathologic specimens.

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  • Statistical analysis using Kaplan-Meier plots, chi-square, and t-tests.

    • Main Results:

    • EGC patients were younger (44 vs. 67 years) with higher albumin levels (4.1 vs. 3.7 mgm/dl).
    • No significant differences in endoscopic or radiographic appearance, tumor location, or lymph node metastasis rates.
    • Median 5-year survival was 100% for EGC versus 15% for ADV (p<0.01).
    • EGC with lymph node metastases had an excellent prognosis; one recurrence was successfully re-resected.

    Conclusions:

    • Early gastric cancer behaves similarly in the US and Japan, with an excellent prognosis.
    • Pre-operative differentiation between EGC and ADV is challenging.
    • An aggressive surgical approach is warranted for all resectable gastric neoplasms.