Prognostische Aspekte des Magenfrühkarzinoms

Abstract

The results of treatment of early gastric carcinoma were analysed in 65 patients. In 33 patients the operation was performed 5 years ago. The 5-year-survival rate was 70%. Prognosis was predominantly influenced by the histology of the tumour. Signet ring cell and anaplastic early carcinomas (diffuse type) had a worse prognosis than intestinal (differentiated) forms. Carcinomas localised wholly in the mucosa had no better prognosis than those penetrating into the submucosa. There is no choice of surgical method according to prognostic criteria as the diagnosis "early gastric carcinoma" can be made only postoperatively from the resection material. Bioptic proof of carcinomatous gastric mucosal changes requires full observation of the rules of cancer surgery.

Chronological Changes in Early Gastric Cancer

“…This was, according to Takagi [5], the most important step for the detec tion of EGC. This opinion corresponds to our own [6] and the experiences of numerous other authors [7][8][9][10][11] because before the introduction of fiberoptic gastroscopy and biopsy the num ber of patients with EGC was small. So we should ask our selves which concrete changes took place with the introduction of these diagnostic methods, e. g.. whether new types of EGC were seen or whether the same types of EGC as known before were found now in a higher number.…”

“…This question could be answered most likely if a sufficient number of EGC, treated in the same institution before and after introduction of fiberoptic gastroscopy, would have been examined. Most studies in Ger many or in Europe which deal with chronological changes in EGC were performed after introduction of fiberoptic gastro scopy [12][13][14], Compared with advanced gastric cancer, EGC has an excellent prognosis [4,11]. The answer to this question is, therefore, not only of historic interest, but should help us to improve our diagnostic and therapeutic results at present and in the future.…”