SELECTION OF TREATMENT FOR MULTIPLE EARLY GASTRIC CANCER FROM THE CLINICOPATHOLOGICAL POINTS OF VIEW

Abstract

In order to select treatment for synchronous multiple early gastric cancer, a clinicopathological study was conducted in 143 lesions of 61 patients with synchronous multiple early gastric cancer resected surgically at our department. Results were as follows: 1) The incidence of synchronous multiple early gastric cancer was 11.7% of all early gastric cancers, and many of the patients were elderly male. 2) Forty-one (50%) of 82 accessory lesions were located at the same segment. Most of the main and accessory lesions were same macroscopic type. 4) On 61 multiple cases, 39 main lesions were well differentiated type, of which 37 accessory lesions were the same. 5) Twenty-eight (34%) of 82 accessory lesions were preoperatively missed lesions including 16 lesions of type 0IIc and 10 lesions of type 0IIb most of which were ≤1.0cm in size and located at the middle part of the stomach. 6) The incidence of lymph node metastasis or vessel invasion of synchronous multiple early gastric cancer were both lower than those of solitary early gastric cancer. We conclude that endoscopic mucosal resection or modified operation can be selected for synchronous multiple early gastric cancer using each selection criteria for treatment for solitary early gastric cancer on condition that postoperative intensive examination of remnant stomach should be performed.