Moderne Chirurgie des Magenfrühkarzinoms

Abstract

Surgical Strategies in Early Gastric Cancer Early gastric cancer represents only 15–25% of all gastric malignancies in the Western world. In contrast, in Japan an increasing incidence of this tumor up to 50% and more could be achieved. In comparison to advanced tumor stages, the prognosis of patients suffering from early gastric cancer is excellent in general, with a 5-year survival rate of up to more than 90%, in particular caused by limited lymphatic spread. The rate of lymph node metastases ranged between 0 and 10% or 10 and 25% and more, respectively, in mucosal or submucosal carcinomas. Furthermore, some subtypes of the mucosal cancer probably may have no infiltration of regional lymph nodes; therefore, curative local resective therapy, as endoscopic mucosal resection or combined laparoscopicendoscopic procedures, is carried out with increased efforts, above all in Japan. But limited local therapy is indicated only in about 5–10% in Western countries. Although taking into account individual and stage-oriented gastric cancer treatment, radical surgical resection including lymph node dissection has to be performed in the majority of patients, to achieve the chance of excellent long-term results after complete tumor resection.