Multiple Gastric Cancers -Review of the Locations of Accompaning Lesions to Improve Decision of Operative Method

Kikuo Koufuji, Teruo Kakegawa, Tetsu Suematsu, Keishirou Aoyagi, Issei Kodama, Jinryo Takeda

First Department of Surgery, Kurume University School of Medicine

A total of 148 cases of multiple primary gastric cancers have been reviewed using Moertel's principles. From 1974 to 1983, there were 39 cases, while in the same length of time from 1984 to 1993, there were 109 cases. We excluded 3 cases of advanced multiple lesions, and reviewed the remaining 106 recent cases. The incidence of type IIa, of differentiated type, and of early (m) cancer were significantly (p<0.01) higher than those in cases of a solitary gastric lesion. Our diagnostic accuracy either using a barium study or endoscopy was only 71.7%. This was due to the fact that the most common type of accompanying lesion in multiple early cancers was superficial type of less than 10 mm in diameter. The diagnostic accuracy for the 15 lesions of minute cancerous foci of less than 5 mm in diameter was only 13.3%, while that of the 13 lesions of adenoma was 33.3%. Almost all of these were found in the A-region. In the same period, we experienced 21 cases of remnant stomach cancer after resection of an initial malignancy. Most of these had occurred more than 10 years after the initial operation. More regular follow-up examinations are recommended for early detection of remnant stomach cancer.

Key words
multiple gastric cancers, accompaning lesions remnant stomach cancer

Reprint requests
Kikuo Koufuji First Department of Surgery, Kurume University School of Medicine
67 Asahi-machi, Kurume-shi, 830 JAPAN

Accepted
June 14, 1995

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