EARLY GASTRIC-CANCER - PROGNOSTIC FACTORS IN 223 PATIENTS

A retrospective study of 223 patients treated for early gastric cancer (EGC) is reported, representing 21.2 per cent of the 1051 patients wi th gastric cancer treated over the same period. Two main types of surg ical procedure were used: subtotal resection of the stomach for EGC of the two lower thirds and total gastrectomy for lesions of the upper t hird. A lymphadenectomy of groups 1 and 2, according to the procedure of the Japanese Research Society for Gastric Cancer (R2 resection), wa s performed in all patients. The mean duration of follow-up was 7.5 ye ars. Univariate analysis showed a significant difference in survival r ates only between patients with and without involved nodes (log rank = 6.05, P = 0.0139). Other prognostic factors were not identified. A bi variate analysis was performed to evaluate the joint effect of node st atus and the Kodama classification: survival rates for patients with E GC of the penetrating (Pen) A type and node positive falls to around 5 7 per cent within 6 years. This group of patients has a tumour that sh ould probably be considered as a 'non-early' lesion. To improve the su rvival of patients with a Pen A, node positive lesion, adjuvant chemot herapy may be appropriate.