Early gastric cancer: Unrecognized indicator of multiple malignancies

The aim of this study was to evaluate the postoperative outcome and occurre nce of second primary malignancies in patients who underwent radical resect ion for early gastric cancer. Altogether 105 patients with early gastric ca ncer underwent radical resection and were followed up for a median period o f 71 months. Overall lethality was analyzed with regard to mortality due to gastric cancer or other causes. Standardized mortality and morbidity ratio s were calculated using data from the Tumor Registry of Lombardy. The 5-yea r survival rate was 82.8% (operative mortality excluded), which was not dif ferent from that expected from an age- and sex-matched Italian population. Ten second primary malignancies were identified, giving a standardized mort ality ratio of 1.12 and a standardized morbidity ratio of 1.50. Patients un dergoing surgery for early gastric cancer (especially the intestinal type) may have a circa 50% higher risk of a second tumor and should be periodical ly checked for other tumors, mainly in the supramesocolic area.