Recurrent death among early gastric cancer patients: 20-years' experience

Six hundred and ninety-six patients, from among a total of 1,868 cases, were diagnosed as having gastric cancer, and underwent surgical treatment at this Medical Institution, between 1972 and 1992. Eighteen patients (2.6%) died of recurrent disease, four (0.6%) tumors being mucosal, and fourteen (2.0%) submucosal, in accordance with depth of invasion. The clinico-pathological findings were analysed to clarify the risk factors of recurrence in patients with early gastric cancer, as follows: (a) submucosal invasion, (b) mixed type IIa+IIc in gross appearance, (c) tumor size more than 40 mm in diameter. In mucosal cancers, recurrence occurred in patients with lymph-vessel invasion and lymph-node metastasis. In terms of the site of the recurrent lesion, the patients had predominantly hepatic recurrence. We conclude that there are specific factors related to the increased risk of recurrence, that can be evaluated pre-operatively. By identifying the risk factors of recurrence, we can optimize the therapeutic approach to these patients.