BACKGROUND: This retrospective study was carried out to review our surgical experience and to define the clinicopathologic profile of early gastric cancer in a Western country with one of the highest incidences in the world. METHODS: Fifty-eight patients who had gastric surgery for early gastric cancer were included in this study. RESULTS: The incidence of early gastric cancer was 13.9% of the patients with resected gastric cancer (58/416). The mean age of these 58 patients at diagnosis was 56.8 +/- 12.3 years (range, 30-81 years) and the male: female ratio was 2.4 : 1. The most common presenting symptom was epigastric pain (52.4%). All patients were treated by surgical resection. Tumors were typically located in the antrum (72.4%), with a predominance of lesser curvature lesions (89.7%). Macroscopically, the majority of the lesions (63.8%) were excavated (types IIc and III). Thirty tumors were intramucosal and 28 extended into the submucosa. Thirty were of the intestinal type and 28 of the diffuse type. The rate of regional lymph node metastasis was 10.4%. The overall 5-year survival rate was 93.9%. CONCLUSIONS: The excellent response to surgical resection of early gastric cancer reported by Japanese authors is reproducible in Western countries even in the presence of regional lymph node metastasis. For this reason an aggressive surgical approach should be taken for all early gastric cancer.
BACKGROUND: This retrospective study was carried out to review our surgical experience and to define the clinicopathologic profile of early gastric cancer in a Western country with one of the highest incidences in the world. METHODS: Fifty-eight patients who had gastric surgery for early gastric cancer were included in this study. RESULTS: The incidence of early gastric cancer was 13.9% of the patients with resected gastric cancer (58/416). The mean age of these 58 patients at diagnosis was 56.8 +/- 12.3 years (range, 30-81 years) and the male: female ratio was 2.4 : 1. The most common presenting symptom was epigastric pain (52.4%). All patients were treated by surgical resection. Tumors were typically located in the antrum (72.4%), with a predominance of lesser curvature lesions (89.7%). Macroscopically, the majority of the lesions (63.8%) were excavated (types IIc and III). Thirty tumors were intramucosal and 28 extended into the submucosa. Thirty were of the intestinal type and 28 of the diffuse type. The rate of regional lymph node metastasis was 10.4%. The overall 5-year survival rate was 93.9%. CONCLUSIONS: The excellent response to surgical resection of early gastric cancer reported by Japanese authors is reproducible in Western countries even in the presence of regional lymph node metastasis. For this reason an aggressive surgical approach should be taken for all early gastric cancer.