[Superficial gastric cancer. Results of surgery in 30 cases (author's transl)]

Gastrectomy was performed in 30 patients with superficial gastric cancer, equivalent to 12 p. cent of cases operated upon for gastric neoplasms since 1970. Presenting signs were epigastralgia in 19 cases (in 12 cases of the ulcer type), external bleeding from the digestive tract in 4 cases, dyspeptic disorders in 2 cases, and anaemia in one patient. The lesion was asymptomatic in 4 cases, while in 3 patients it was detected by endoscopy after polypectomy or for achlorhydria. In one case the lesion was discovered completely fortuitously. Cancer was suspected by the endoscopist from gross pathological findings in 7 of the 30 cases. An adenocarcinoma was diagnosed after biopsy in 26 cases, and suspected in the remaining 4 patients. Sub-total gastrectomy was employed in 27 cases, total gastrectomy in 2 cases, and extension to a total gastrectomy in one patient. Gross pathology showed cancer of type I : 8 cases, type II (IIa : 1, IIb : 0, IIc : 10) : 11 cases, type III : 6 cases, and mixed types IIc + III : 5 cases. The submucosa was invaded 17 times, the other 13 lesions involving the mucosa only. There were no immediate postoperative deaths. Three patients were not seen again, while 7 died from secondary causes : 5 for reasons unrelated to their cancer and 2 from unknown causes. By applying strict attention to surgical procedures and precise examination of histological data it should be possible to obtain postoperative survivals comparable to those of Japanese series (80 to 90 p. cent at 5 years, 70 p. cent at 10 years).