Early gastric cancer at a third-level hospital in Barcelona in 1981-1990. Clinical considerations

The records from seventy cases of early gastric cancer (EGC) diagnosed at the Hospital de la Santa Cruz y San Pablo in Barcelona during 1981-1990 were reviewed in order to analyze their clinical features and their influence on survival. There was a male predominance (47/23). The disease was seen mostly in patients who were 60-70 years old, although women were younger than men. The most frequent symptom was epigastric pain, more commonly referred in ulcerated forms of EGC. Protruded forms resulted in digestive haemorrhage. Barium meal examination of the upper digestive tract and gastroscopic examination (without histologic study) only revealed about half of the lesions. So it is very important to get some material for histological studies even in apparently benign lesions. EGC was mostly located at the antrum (68.1%). These antral tumours used to have lymph node metastases more frequently than the rest. Tumours were larger in women than in men. EGC with greater size showed deeper infiltration, more lymph node involvement and higher recurrence risk. Another malignancy--besides EGC--was seen in 8.2% of the patients. This event implied a 40% of mortality. Development of recurrence also meant a high mortality risk. Patients with big, multifocal tumours and with lymph node metastases were prone to recurrence of the disease. In this study, development of recurrence and detection of another malignancy have become the clinical features with more influence over survival.