A Pathological Type Oriented Surgical Treatment for Multifocal Gastric Cancer

Abstract

The pathological characteristics, location of the lesions, lymph node metastasis and metachronous multiple lesions in 323 patietns with multifocal cancer were studied. In macroscopic findings, the protruded type and flat type were observed more frequently in multifocal cancer than in single cancer. Lesions were close to each other in 77% of patients younger than 49 years, and they were apart from each other in 70% of patients older than 50 years. The incidence of lymph node metastasis for multifocal cancer (33.3%) was lower than that for single cancer (43.8%) (p<0.05). Within 10 years after partial gastrectomy for cancer, 80% of remnant stomach cancers were detected in regions apart from the anastomosis, and more than 15 years after the first operation, 50% of them were detected in the region of anastomosis. Before a partial gastrectomy the stomach should be examined carefully to avoid leaving cancer. After gastrectomy, endoscopy should be performed to detect any metachronous multiple lesions.