[Choice of operative procedure in early gastric cancer]

Early gastric cancer, i.e., a tumor of intestinal or diffuse cell type confined to the mucosa or submucosa, has so far been found in only 6% of all cases of gastric carcinoma in Europe, whereas the Japanese report a percentage of 30%. This tumor stage has a very good prognosis with a survival rate of 95% or 87%. If the tumor lies in the distal half of the stomach, a subtotal gastrectomy is justified, whereas we recommend total gastrectomy in a more proximal localization. In exceptional cases such as a polypous tumor situated near the cardia, an endoscopic resection or local excision may be considered.