Clinicopathological Study of Multifocal Gastric Cancer

Emiko Yanadori, Hidetoshi Oguma, Tuyoshi Sasagawa, Youichi Kitamura and Ken Takasaki

Department of Gastroenterological Surgery, Tokyo Women's Medical University

Between 1968 and the end of 1994, 447 cases of synchronous multiple gastric cancer were treated surgically in our institution. The incidence of multiple cancer was 6.7%, and when compared to solitary cancer, elderly men predominated, and the main lesions were typically described as a protruding early cancer that was a tubular adenocarcinoma histologically. Early-early cancer was a more frequent combination of main and secondary cancer than early-advanced cancer. In about 90%, multiple lesions were present in the same and/or in neighboring portions of the stomach. The accuracy of the preoperative diagnosis of multiple gastric cancer was 40%. The secondary tumors were mucosal cancers and less than 10 mm in size. The 5-year survival rate of the multiple cancer patients was similar to that of the solitary cancer patients in every stage, and the incidence of metachronous cancer in the remnant stomach (4.7%) was differed significantly from that of the solitary cancer (1.7%), but it was less than 5%. In conclusion no special strategy seemed to be necessary when planning surgery for synchronous multiple gastric cancer. The extent of surgery should be determined by tumor characters such as tumor depth and tumor site likewise solitary gastric cancer, but an even more discreet attitude might be required in the follow-up period.

Key words
multiple gastric cancer, remnant gastric cancer

Reprint requests
Emiko Yanadori Department of Gastroenterological Surgery, Tokyo Women's Medical University 8-1 Kawada-cho, Sinjuku-ku, Tokyo, 162-8666 JAPAN

Accepted
October 31, 2000

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