Abstract
A clinicopathological study on factors influencing the prognosis of early gastric cancer, as viewed from late results, was investigated. Since cases of late recurrence after a lapse of 5 years or more are encountered even in early gastric cancer, the 10-year survival rate was used in this study and the cumulative survival rate based on the crude survival rate and relative survival rate with the age and sex taken into consideration were used in calculating the survival rate. The subjects were 178 cases of early gastric cancer (corresponding to about 19.2 % of 928 cases of primary gastric cancer) which were resected at the department of surgery, Showa University, in the past 23 yeays (Mar. 1956-Dec. 1978) . In conducting the following study, however, 14 cases of multiple cancer and 3 other cases (ow (+) cases) were excluded and the remaining 161 cases were used. The age ranged from 26 to 76 years (average age 54.3 years), the male to female ratio being 1.2: 1. Ten factors possibly influencing the prognosis of early gastric cancer, that is, the age, sex, location of cancerous lesion, the longest diameter, macroscopic type, depth of invasion, histologic type, vascular invasion, lymph node metastasis and infiltrative growth (INF) were studied to obtain results as follows: It was in four factors, that is, age, histologic type, vascular invasion and infiltrative growth form that a significant difference in the cumulative survival rate was observed. As for the relative survival rate, the difference was significant only in vascular invasion because of the strictness of the test of significance. However, it was concluded that of the factors showing no significant difference, the location, macroscopic type and lymph node metastasis are important as factors influencing the prognosis of early gastric cancer. Youth, the location being in A, the macroscopictype being a mixed type (IIc+II a), submucosal involvement (sm cancer), the histologic type being well differentiated type, vascular invasion positive and the infiltrative growth form being α-β appeared to constitute a typical picture of early gastric cancer with the high risk of recurrence. When postoperative deaths in early gastric cancer were examined, 26 (16.1%) of the 161 cases died. There were 7 cases (26.9%) that died of recurrence of cancer. The mode of recurrence often seen was hematogeneous recurrence, mainly involving the liver, which was found in 5 out of 7 cases. As for the time at recurrence, it was a little more than three years in many of the deaths from recurrence.
