Abstract
A histopathological study was made on 512 cases of gastric cancer that were obtained surgically from aged patients (73 years old in the mean age) in Tokyo Metropolitan Geriatric Hospital. They were composed of 408 cases of differentiated-type (80%) and 104 cases of undifferentiated-type (20%). There were 75 cases of gastric cancer with multiple independent cancer lesions (hereafter referred to as multiple gastric cancer), in which 71 cases were histologically diagnosed as multiple gastric cancer composed of 2-5 cancer lesions of differentiatedtype only. The multiple gastric cancer of differentiatedtype was more common in men; the ratio of males to females was about 3 to 1 in the present study. The maximum incidence was around the age of 70. Regarding the depth of invasion of the lesion, 21 out of 71 cases were combination of intramucosal cancer only, 35 cases of intramucosal cancer and invasive cancer, and 15 cases of invasive cancer only. The maximum diameter of each lesion and its location within the stomach were assessed in 14 cases in which the distance between centers of two lesions ranged in 3.9cm and compared with those of 49 cases of single intramucosal gastric cancer in aged patients. The results has suggested that there is a great possibility that collision of multiple cancer lesions resulted in a single intramucosal gastric cancer over 3.1cm in the maximum diameter in aged patients. Autopsy examination was performed in 17 out of 71 cases which had undergone surgical resection of multiple gastric cancer of differentiated-type. In 4 out of 17 cases, the major cause of death was ascribed to malignant neoplasm occurred in organs other than the stomach, and 2 out of 4 cases had triple carcinomas; one, triple carcinomas in the stomach, liver and colon, and the other, those in the stomach, esophagus and colon.
