Problems in Patients with Multiple Gastric Cancers -With Special References to Double Cancers, Immunocompetence and Postoperative Survival-

Michio Maeta, Kuniyuki Katano, Atsuo Oka, Hiroshi Yamashiro, Masahide Ikeguchi, Norio Shimizu, Nobuaki Kaibara

First Department of Surgery, Tottori University School of Medicine

The clinicopathologic findings were investigated in 164 patients with simultaneous multiple gastric cancers (MGC). In terms of the combination of gastric cancers, patients with MGC were divided into group A [advanced plus advanced cancers (n=14)] , group B [advanced plus early cancers n=69)J and group C [early plus early cancers (n=81)] . The number of patients in group C has tended to increase recently. With respect to the direction and distance along the long axis in the stomach between the main and associated lesions, 50 had both lesions in parallel, 63 had their associated lesions at the distal side of the main lesion (mean 3.2 cm) and 51 had the associated lesions at the proximal side (2.2 cm) and 51 had the associated lesions at the proximal side (2.2 cm). The rate of postoperative diagnosis of the associated lesions was low; it was only 22% (11/49) in patients whose lesions were less than 1.0 cm in diameter. Patients with MGC were associated with a significantly higher rate (12.2%) of double cancers that developed in organs other than the stomach than that (6.8%) in patients with single gastric cancer (SGC). Preoperative immunocompetence in patients with MGC showed a decreased level compared with that in patients with SGC. It was suggested that there might be a possible association between imparied immunosuppression and the development of both MGC and double cancers. The postoperative survival rate in patients with MGC was lower than that in patients with SGC; there was a significant difference between stages I and III. Based on these analyses, careful observation of patients with MGC should be carried out before and after surgery.

Key words
simultaneous multiple gastric cancers, postoperative survival, immunocompetence

Reprint requests
Michio Maeta First Department of Surgery, Tottori University School of Medicine
36-1 Nishimachi, Yonago, 683 JAPAN

Accepted
June 14, 1995

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