Abstract
Endoscopic treatment for early gastric cancer in 2072 patients treated from 1972 to 1991, with particu-lar reference to surgical applications, indications and endoscopic techniques, is reviewed. Among them, Early gastric cancer was resected in 788 (43%). Investigation of 10-year relative cumulative survival rate revealed that 97.69% survivors were pathologically negative for lymph node methastasis. Ten-year relative cumulative survival rate of patients in whom cancer cells remained intramucosal layer, i, e. carcinoma in situ, was 100%. We performed a retrospective study at our Univer-sity Hospital of the relationship of lymph node methastases to endoscopic type and tumor size, in 631 patients who underwent surgery for simple early gastric cancer. No lymph node metastasis was observed in the following patient groups : (1) those with protruded type of early gastric cancer and tumor size less than 2.5 cm in diameter, (2) those with the depressed type, lesion size less than 2.0 cm in diameter and no associated ulcer or ulcer scar, and (3) those with mixed type with lesion size less than 1.5 cm in diameter. Furthermore, we evaluated the technical aspects of endoscopic treatment in 91 patients with early gastric cancer. On the basis of both lymph node metastasis findings and analyses of the technical aspects of endoscopic treatment, that we conclude endoscopic treatment is useful in the curative treatment of early gastric cancer, is especially useful for small tumors less than lcm in size, with no associated ulcer.
