With recent advances and improvement in gastrofiberoptic endoscopy, the number of multiple gastric cancers appears to have increased. The study of multiple gastric cancer is of utmost importance in the management of cancer of the gastric remnant
and in
the epidemiology and histogenesis of gastric cancer. We reviewed 49 patients with synchronous multiple gastric cancers and 1290 patients with single gastric cancer, who were operated on at the Department of Surgery, Chonnam University Hospital
from
1985
to 1994.
@ES Comparing the two types of gastric cancer, the results were as follows:
@EN 1) Incidence of synchronous multiple gastric gastric cancers was 3.8%. The patients with multiple gastric cancers were younger than those with single with single gastric cancer. The incidence of multiple gastric cancer was significantly
higher
in
male patients than in female patients (sex ratio; 5.1 : 1), (p<0.05).
2) The number of carcinomas per stomachs with synchronous multiple gastric cancers ranged from two to three: 39 cases had 2 lesions and 10 cases had 3 lesions. for a total 108 lesions in the 49 patients. The lesions at the body and cardia were
relatively more common in patients with multiple gastric cancers than with single gastric cancer (p<0.001)
3) Regarding the histologic types found in multiple gastric cancers, 36.7% of the cases were of the poorly differentiated type and 16.4% of the cases were of the well differentiated type.
4) Early cancers were observed more frequently in the multiple gastric cancers than in the single gastric cancers(p<0.001). The 40.7% of patients with multiple cancer were stage Ia.
5) Metastasis to lymph nodes appeared 18.4%, 10.2% and 8.2%, in the N1 group, N2 group, and N3 group, respectively.
6) Regarding the operative methods, total gastrectomy was more frequently done in the multiple gastric cancer(38.8%) than in the single gastric cancer(19.5%) (p<0.01).
7) Recurrences were noted in 8 cases of multiple gastric cancers(16.3%). 4 cases had peitoneal seeding, 3 cases had liver metastasis, and 1 case had retroperitoneal metastasis respectively. The 5 year survival rate was 71.1% in patients with
multiple
gastric cancers and 45.2% in patients with single gastric cancer.
The results showed that the multiple Gastric cancers were more prevalent in male patients, detected in earlier stage, and had better prognosis than single cancer. The careful preoperative, intraoperative evaluation and post operative follow-up
are
essential to detect any missed lesions in the remnant stomach.
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