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Early gastric cancer: contribution to diagnosis and results of surgical treatment

BACKGROUND: To analysis diagnosis and treatment of patients with early gastric cancer. METHODS: The author studied 34 patients with "Early Gastric Cancer" (EGC) treated at Faculdade de Ciências Médicas da Pontifícia Universidade Católica de Campinas from january 1978 to december 1998. RESULTS: The diagnosis were performed by endoscopy and biopsy, but in two patients (5,9%) the biopsy showed only atipic cells in gastric ulcer. In the other 32, biopsy showed adenocarcinoma. The most common localization of the neoplasia was in the gastric antrum and macroscopic types IIc and IIc + III predominated. The mucosal type appeared more often than the submucosal type and all patients had lymph nodes free of cancer invasion. All 34 patients underwent subtotal gastrectomy with D2 lymphadenectomy and in 67,3% of them the Roux in Y reconstruction was perfomed. Follow up ranged from 17 days to 21 years and six months and showed complications in only three cases (8,8%). Two patients (5,8%) died: one because of postoperative complications and the other because of tumor recurrence. CONCLUSIONS: EGC incidence in this study (8,7%) is similar to that in the occidental countries literature, but is very low if compared to japanese series. These results emphasize the importance of periodic endoscopic examination of patients with risc factors for stomach neoplasic disease. When the CGP is limited to mucosa, lymph nodes are free and there are no distant metastasis, a very good survival is possible.

Stomach neoplasms; Gastrectomy; Diagnostic; Surgery


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