Pathologic Features and Long‐term Results in Early Gastric Cancer: Report of 116 Cases 8–13 Years after Surgery

• Published in: World journal of surgery Vol. 27; no. 2; pp. 149 - 152
• Main Authors: Basili, Giancarlo, Nesi, Gabriella, Barchielli, Alessandro, Manetti, Andrea, Biliotti, Giancarlo
• Format: Journal Article
• Language: English
• Published: New York Springer‐Verlag 01.02.2003; Springer; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Cumulative Survival; Early Gastric Cancer; Female; Follow-Up Studies; Gastrectomy; Gastric Wall; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Lymph Node Metastasis; Lymphatic Metastasis; Male; Medical sciences; Middle Aged; Neoplasm Invasiveness; Neoplasm Recurrence, Local - mortality; Neoplasm Recurrence, Local - pathology; Postoperative Death; Prognosis; Proportional Hazards Models; Stomach Neoplasms - mortality; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery; Stomach, duodenum, intestine, rectum, anus; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Survival Analysis; Treatment Outcome; Tumors; Histological grading; Human; Stomach; Relapse; Treatment efficiency; Mortality; Early phase; Stage classification; Clinical form; Malignant tumor; Gastrectomy; Epidemiology; Incidence; Pathology; Surgery; Cohort study; Digestive diseases; Survival curve; Gastric disease
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-002-6414-5

One hundred sixteen patients who underwent surgery for early gastric cancer (EGC) at Careggi General Hospital in Florence between 1987 and 1992 were studied with regard to clinicopathologic features, incidence, and recurrence of the disease. The overall 5‐year cumulative survival rate was 87.5%, and the disease‐specific 5‐year survival rate was 88.2%. EGC was limited to the mucosa in 43 patients (37%), while it infiltrated the submucosa in 73 others (63%). At the time of surgery, 9.5% of patients were found to have lymph node metastasis, always concomitant with submucosal invasion. There was 1 postoperative death (0.8%); 16 patients (13.7%) died of tumor recurrence, and 20 (17.2%) died of unrelated causes. Analysis of recurrence showed an intestinal histotype in 13 patients (81.2%), submucosal infiltration in 14 patients (87.5%), a Pen‐A growth pattern in 8 patients (50%), and lymph node involvement in 3 patients (18.7%). The Cox proportional hazard model indicated that age and depth of wall invasion were statistically significant. The best predictor of survival appears to be the depth of invasion within the gastric wall. The claim by several investigators that prognosis for EGC is also associated with the presence of lymph node involvement is not supported by the present study. The postoperative 5‐year survival rate in node‐negative patients was 88.8% compared to 81.8% in node‐positive patients (p = 0.296).