Early gastric cancer

Diagnosis, surgical treatment and follow-up of 45 cases

Roberto Sigon, Vincenzo Canzonieri, Renato Cannizzaro, Bruno Pasquotti, Alessandro Cattelan, Carlo Rossi, Antonino Carbone

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Aims and background: The 5-year survival rate of early gastric cancer (EGC) is 85%-100% after 'curative' resection, as compared to 20%-30% in advanced gastric cancer (AGC). Because of this relatively high cure rate, the interest in the diagnosis and therapy of EGC has been steadily increasing. The present study, based on 45 EGCs, is aimed at a critical evaluation of the diagnostic procedures and surgical options. Methods and results: Forty-five patients with early gastric cancer (27 men and 18 women; median age, 62 years; range, 2884) were diagnosed and operated on. They represented 22.5% of all patients with gastric cancer (200) treated in the period July 1987 to January 1998. Forty-one patients were from the northeastern part of Italy. The most frequent symptom was epigastric pain (84%). Barium upper gastrointestinal radiography findings were strongly suggestive of malignancy in 41 cases (91%). Preoperative histopathological diagnosis of adenocarcinoma was performed in 43 cases (95.5%). In two cases (4.5%) severe epithelial dysplasia (associated with ulcer) was the first diagnosis, but the final diagnosis on the basis of the resected specimens was a well differentiated adenocarcinoma. The primary surgical procedure included i) subtotal distal resection (37 cases) with Billroth II (33) and Billroth I (4) reconstructions; ii) total gastrectomy (3) for proximal neoplastic extension; iii) proximal gastric resection (2) for cardial cancer; iv) degastro-total gastrectomy (3) for cancer of the stump. Two patients, previously treated with conservative surgery, underwent degastro-total gastrectomy for neoplastic microfocal extension to the margin of resection and for early anastomotic recurrence, respectively. Mural infiltration was limited to the mucosa and submucosa in 27 and 18 cases, respectively. Lymph node metastases were found in three mucosal and five submucosal tumor cases, involving either the first or the second echelon. No operative deaths or postsurgical complications occurred in this series. In the follow-up period (median, 36 months; range, 3-120) four patients died due to other causes; one developed liver metastases, another developed oropharyngeal cancer and two died of biopsy-proven lung cancer without evidence of gastric cancer recurrence. Conclusions: The clinical presentation of EGC is aspecific. Preoperative endoscopy with biopsy remains the most sensitive diagnostic procedure. For treatment, subtotal distal gastric resection with lymphadenectomy is the 'gold standard' but in some instances total gastrectomy may be indicated. Accurate pathological examination establishes the depth of infiltration, as well as the superficial extension of tumors and the lymph node status. Although the prognosis of EGC is favorable, a medium-term follow-up should be planned.

Original languageEnglish
Pages (from-to)547-551
Number of pages5
JournalTumori
Volume84
Issue number5
Publication statusPublished - Sep 1998

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Early Detection of Cancer
Stomach Neoplasms
Gastrectomy
Gastroenterostomy
Therapeutics
Neoplasms
Stomach
Adenocarcinoma
Lymph Nodes
Neoplasm Metastasis
Oropharyngeal Neoplasms
Biopsy
Recurrence
Barium
Lymph Node Excision
Radiography
Italy
Endoscopy
Ulcer
Lung Neoplasms

Keywords

  • Diagnosis
  • Early gastric cancer
  • Gastric cancer
  • Therapy

ASJC Scopus subject areas

  • Cancer Research

Cite this

Sigon, R., Canzonieri, V., Cannizzaro, R., Pasquotti, B., Cattelan, A., Rossi, C., & Carbone, A. (1998). Early gastric cancer: Diagnosis, surgical treatment and follow-up of 45 cases. Tumori, 84(5), 547-551.

Early gastric cancer : Diagnosis, surgical treatment and follow-up of 45 cases. / Sigon, Roberto; Canzonieri, Vincenzo; Cannizzaro, Renato; Pasquotti, Bruno; Cattelan, Alessandro; Rossi, Carlo; Carbone, Antonino.

In: Tumori, Vol. 84, No. 5, 09.1998, p. 547-551.

Research output: Contribution to journalArticle

Sigon, R, Canzonieri, V, Cannizzaro, R, Pasquotti, B, Cattelan, A, Rossi, C & Carbone, A 1998, 'Early gastric cancer: Diagnosis, surgical treatment and follow-up of 45 cases', Tumori, vol. 84, no. 5, pp. 547-551.
Sigon R, Canzonieri V, Cannizzaro R, Pasquotti B, Cattelan A, Rossi C et al. Early gastric cancer: Diagnosis, surgical treatment and follow-up of 45 cases. Tumori. 1998 Sep;84(5):547-551.
Sigon, Roberto ; Canzonieri, Vincenzo ; Cannizzaro, Renato ; Pasquotti, Bruno ; Cattelan, Alessandro ; Rossi, Carlo ; Carbone, Antonino. / Early gastric cancer : Diagnosis, surgical treatment and follow-up of 45 cases. In: Tumori. 1998 ; Vol. 84, No. 5. pp. 547-551.
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