World Journal of Surgery

, Volume 22, Issue 8, pp 869–873 | Cite as

Tumor Recurrence following Resection for Early Gastric Carcinoma and Its Implications for a Policy of Limited Resection

  • Tsutomu Namieno
  • Kazumitsu Koito
  • Tsunemi Higashi
  • Tsuyoshi Shimamura
  • Kenichiro Yamashita
  • Yukifumi Kondo

Abstract. Some patients suffer postoperative recurrence after curative resection of early gastric carcinoma. This study reviewed consecutive patients with a single primary lesion and analyzed the relation between the pathologic findings and recurrence of early gastric carcinomas for determining indications for limited surgery. Among the 1585 consecutive patients with a solitary primary lesion of an early gastric carcinoma who had undergone curative surgery between 1963 and 1989 at one general hospital, pathologic findings relating to recurrence were analyzed according to Japan’s General Rules for Gastric Cancer Study in Surgery and Pathology. Of these carcinomas, mucosal carcinomas comprised 701 (44.2%) and submucosal ones 884 (55.8%). The total recurrence rate in this series was 1.0%. Submucosal carcinomas (1.6%) were significantly (

p < 0.02) more recurrent than mucosal ones (0.29%). Of the 16 patients with recurrence, 10 (62.5%) died within 5 years after surgery, frequently because of blood-borne metastasis. Macroscopically elevated components, the degree of histologic differentiation, and lymph node metastasis significantly contributed to the postoperative recurrence. After detailed analysis of submucosal carcinomas, it is strongly suspected that carcinomas with a macroscopically elevated component were significantly associated with nodal involvement and microvessel invasion, and that these abnormalities lead to recurrence. Among the early gastric carcinomas, differentiated submucosal carcinomas with a macroscopically elevated component, lymph node metastasis, or both have the most potential of recurrence after surgery. Mucosal carcinomas must be restricted to limited surgery, but, blood-borne metastasis should be carefully avoided.

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Copyright information

© 1997 by the Société Internationale de Chir ugie

Authors and Affiliations

  • Tsutomu Namieno
    • 1
  • Kazumitsu Koito
    • 3
  • Tsunemi Higashi
    • 1
  • Tsuyoshi Shimamura
    • 2
  • Kenichiro Yamashita
    • 2
  • Yukifumi Kondo
    • 1
  1. 1.Department of Surgery, Sapporo-Kosei General Hospital, N-3, E-8, Chuo-ku, Sapporo 060, JapanJP
  2. 2.First Department of Surgery, Hokkaido University School of Medicine, N-15, W-7, Kita-ku, Sapporo 060, JapanJP
  3. 3.Department of Radiology, Sapporo Medical University, S-1, W-16, Chuo-ku, Sapporo 060, JapanJP

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