The Detection of the Assesory Lesions in Synchronous Multiple Gastric Cancer and the Early Detection of Metachronous Gastric Cancer

Osamu Hosokawa, Jouji Tsuda, Kunishige Watanabe, Yutaka Tanigawa, Shinji Shirasaki, Hiroyuki Hayashi

Department of Surgery, Fukui Prefectural Hospital

From 1969 to 1993, 375 cases of synchronous multiple gastric cancer and 34 cases of metachronous gastric cancer were treated in our hospital. The incidence of synchronous multiple cancer was12.1% in cases of early cancer, 6.2% in cases of advanced cancer and 8.9% in total. The assessory lesions of synchronous multiple cancer were dtected in 38.1% of cases preoperatively, in 33.8% macroscopically and in 28.1% microscopically. There was no significant difference in macroscopic type, depth or size between the lesions which were detected preoperatively and those which were detected macroscopically. However, the lesions which were detected microscopically differed significantly from the others. In 41.4% of multiple cancers, the iesions missed preoperatively were located nearer to the cut wedge of stomach than the main lesion. It is important to observe carefully the lesser curvature of the gastric body in order to prevent residual accessory lesions. The incidence of metachronous gastric cancer was high in the cases of cardiac resection. The rate of early cancer in metachronous cancer was related to the interval from the first operation to the diagnosis. It is suggested that examination for Ebstein-Barr virus in carcinoma tissues was useful to select the high risk group with metachronous cancer.

Key words
synchronous multiple gastric cancer, metachronous gastric cancer, Ebsetin-Barr virus in gastric cancer

Reprint requests
Osamu Hosokawa Department of Surgery, Fukui Prefectural Hospital
2-8-1 Yotsui, Fukui-shi, 910 JAPAN

Accepted
June 14, 1995

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