Early gastric carcinoma with special reference to macroscopic classification

Abstract

During a period beginning in 1946 and ending in October of 1978, 1000 cases of solitary early gastric carcinoma were operated on at the Cancer Institute Hospital, Tokyo, Japan. The clinical characteristics and the macroscopic and chronological changes were studied in these cases. Early gastric carcinoma comprised one third of all resected gastric carcinoma. If early gastric carcinoma was divided into two groups, the depressed and the elevated, the former was more common. By location, the depressed type lesions were more frequently seen in the middle third of the stomach and the elevated type lesions in the lower third. By age, distribution of the elevated type lesions showed a peak with a mode at the age of 60 to 69 years and of the depressed type, a plateau with a mode at the age of 50 to 59 years. The relative incidence of the elevated type of gastric carcinoma to the depressed type was one to four. In depth of invasion, the mucosa and the submucosa were equally involved. Lymph node metastases were encountered in 12.7% of early gastric carcinoma cases. The incidence of positive nodes in mucosal carcinoma was 3.4% and that of submucosal lesions was 21.7%. Of the elevated type carcinoma, 20.9% of the cases had positive nodes. The 5-year survival rate of the patients with surgery for cure was 93.8% in contrast to 56.5% of those with palliative resection.

Liver metastasis in gastric cancer with particular reference to lymphatic advancement

“…Other reported findings in regard to liver metastasis have shown that the risk factor with the greatest significance was lymph node metastasis [5,6] and that the proportion of liver metastasis increased with an increased degree of lymph node metastasis. Also, liver metastasis accounted for 50% of the recurrences in early gastric carcinoma [13]. The majority of patients with early gastric cancer with recurrence and liver metastasis had lymph node involvement [14,15].…”

Risk of Lymph Node Metastases from Early Gastric Cancer in Relation to Depth of Invasion: Experience in a Single Institution

“…Many investigations have shown that the presence of lymph node metastasis is the most important prognostic factor for patients with early gastric cancer and has a significant influence on the selection of possible treatment (Ohta et al, 1987;Haves et al, 1996). Although radical gastrectomy including lymph node dissection has been recognized as the standard surgical operation for early gastric cancer, unnecessary surgery could be avoided and endoscopic treatment might be a consideration in patients with early gastric cancer with negligible risk of lymph node metastasis.…”

A Potential Role of Collagens Expression in Distinguishing Between Premalignant and Malignant Lesions in Stomach

“…The high mortality is partially due to delayed diagnosis caused by lack of specific early symptoms of gastric cancer. The 5-year survival rate in advanced gastric cancer patients is only about 20%, whereas that in early-stage gastric cancer is $60% (Ohta et al, 1987;Endo and Habu, 1990;Santoro et al, 1991). It has been widely documented that the majority of gastric cancer results from precancerous lesions (Correa et al, 1975;Coma del Corral et al, 1990;Meining et al, 2002).…”