Synchronous multiple early gastric carcinoma: A study of 178 cases

Over the past 3 decades, ending in 1979, resection has been performed in 7,220 patients with gastric carcinoma. Synchronous multiple gastric carcinoma, according to the diagnostic criteria of Moertel, was found in 468, of which 178 (38%) were “early.” There were 135 double, 33 triple, and 10 quadruple early carcinomas. Fewer than one‐third of the smaller tumors were diagnosed preoperatively, and 61.5% of the smaller lesions were less than 10 mm in diameter. In 53% of the patients, the smaller lesions were in the lower one‐third of the stomach with the main lesion in the upper one‐third, whereas in 13% the smaller neoplasms were located in the upper one‐third of the stomach with the main lesion in the lower one‐third. The clinical significance of the smaller lesions was their location relative to the resection line. When planning treatment of gastric carcinoma, it is important to evaluate the whole stomach before and during the operation and after examining the resected specimen. The 5‐year survival rate for patients with multiple early gastric carcinoma was 85.8%.