Early gastric cancer at the Hôtel-Dieu de Montréal: a 30-year review

Early gastric cancer is usually defined as a lesion involving the mucosa alone or the mucosa and submucosa, regardless of whether lymph-node metastases are present. Between 1948 and 1978, 1295 gastric cancers were diagnosed at the Hôtel-Dieu de Montréal. Of these, 65 (5%) were early gastric cancers. Sixty of the 64 patients underwent gastric resection for cure. The other four cancers were found incidentally at autopsy. One patient (1.7%) died following operation. Ten patients were followed up for less than 5 years and therefore were excluded from survival analysis, as were 6 patients who died of unrelated causes. Forty-one of 43 patients survived, free of disease, for more than 5 years following operation, a survival rate of 95.3%. The annual yield of early gastric cancers has remained relatively constants since 1948, even with a decreasing number of gastric cancers treated at the hospital. The advent of fiberoptic endoscopy significantly (P less than 0.005) increased the number of early gastric cancers detected. Further improvements will depend on a more vigorous approach to endoscopy, especially in high-risk patients. A refined radiologic technique, including double-contrast roentgenography after a barium meal, was diagnostic in all patients who underwent operation in this study.