A Study on Cases of Death due to Recurrence in Early Gastric Cancer

Hideo Tezuka, Hiroyoshi Suzuki, Youichi Kitamura, Tsuyoshi Sasagawa, Shigeko Takeuchi, Takashi Haratsuka, Takayuki Tanaka, Kiyotaka Yamamoto, Yutaka Yoshida

The Institute of Gastroenterology, Tokyo Women's Medical College

Deaths from recurrence in 42 of 1662 patients with resected early gastric cancer were studied (recurrent rate, 2.5%). (1) The recurrent rate was higher for submucosal cancer than for mucosal cancer (3.9% and l.3% respectively). (2) The recurrent type was most frequently hematogenous, mainly in the liver (43.8%), which was followed by the lymphatic type (28.1%). (3) As for the time of recurrence, 73.9% were within 5 years, in particular 60% of hematogenous recurrence appearing within 3 years, while others (26.1%), mainly local recurrence, appeared after 5 years. (4) Compared with patients, with no recurrence, vascular invasion and lymph node metastasis had a notably higher rate in those with recurrence (41.7%and 38.9% respectively, significant at p<0.05). (5) The types of submucosal layer invasion were most frequently lymphatic (28.6%), then venous invasion followed by welldifferentiated tubular adenocarcinoma. We suspected there was a certain relationship between submucosal layer invasion and recurren type (6) Lymph node resection higher than R2 reduced the recurrent rate from 3.3% to 2.2% compared with that of RO-l except hematogenous recurrence.

Key words
early gastric cancer, recurrent death in early gastric cancer, types of submucosal layer invasion in early gastric cancer, recurrent type in early gastric cancer

Reprint requests
Hideo Tezuka The lnstitute of Gastroenterology, Tokyo Women's Medical College
8-l Kawada-cho, Shinjuku-ku, Tokyo, 162 JAPAN

Accepted
May 9, 1990

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