PREFERRED THERAPEUTIC CHOICE FOR SYNCHRONOUS MULTIPLE EARLY GASTRIC CANCER

Abstract

This study was conducted to examine therapies for synchronous multiple early gastric cancer in terms of clinicopathological characteristics. Subjects were 184 patients with 232 lesions who underwent partial gastrectomy or total gastrectomy for early gastric cancer in a period from 1986 to 1993. Of these 184 patients, 37 patients (20.1%) had synchronous multiple early gastric cancer. Aged patients whose main lesion was differentiated and elevated lesion locating in the area C or A tended to have accessory lesions. Histologically, 89.2% of the acessory lesions had the same type as the main lesions had and in many cases, macroscopically, accessory lesion were much the same as the main lesions. Depressed and flat accessory lesions, measuring 5 mm or less, were prone to be overlooked on preoperative examination. It is inferred that multiple lesions might develop from the same background mucosa. We have to decide resection areas in surgery by considering the background mucosae not to pass over the accessory lesions. For the patients with high surgical risk, endoscopic mucosal resection (EMR) becomes a more curative therapy if we consider the chlinicopathological characteristics of multiple early gastric cancer on preoperative examination and strictly follow up after the operation.