CAUSES OF DEATH AND RECURRENCE AFTER SURGERY FOR EARLY GASTRIC-CANCER

The postoperative course of 172 patients with early gastric cancer (EG C) was followed for a median 7 years to evaluate the causes of death, incidence and patterns of recurrence, and characteristic findings in t he recurrent cases. The cumulative 10-year mortality rate (+/- SE) was 22 +/- 3.7%. Seven patients (4.1%) died of operative mortality, 11 (6 .4%) died of a recurrence of the gastric cancer, and 13 (7.6%) died of unrelated causes. Unrelated causes of death were metachronous primary cancer (n = 6), cardiovascular disease (n = 2), pneumonia (n = 3), se psis (n = 1), and car accident (n = 1). Four patients died from gastri c stump recurrence, three from liver metastases, two from lymph node m etastases, and two from peritoneal dissemination. Using Cox multivaria te analysis, histologic type had the most significant effect on recurr ence. Although influenced bg the tumor nature, the EGC prognosis is re latively good. Based on the results of this study, particularly in Wes tern institutions, histologic examination of resection margins and lym phadenectomy should be improved. Moreover, patients must be carefully followed for late recurrence and metachronous cancer.