[Studies on recurrent and metastatic cases of the early stomach cancer--from diagnostic aspect].

: There were 256 cases of the early stomach cancer resected, from 1967 to '77 in National Hospital-Sapporo. First, 4 recurrent cases of these 256 cases (1.6%) are analyzed and concluded. 1) Common items of these recurrent cases were male and submucosal invasion in depth of cancer. 2) Modes of recurrence of the gastric remnant were shown in 3 of 4 recurrent cases. These 3 cases died within 6 months, on the average, from the diagnosis of recurrence. Therefore, earlier detection and operation of recurrent cancer is important. 3) There are some cases in which the possibility of multiple or double cancers exist, so careful examination before initial operation is most necessary. Second, the early stomach cancers with metastasis to the regional lymph nodes (n+ group) are analyzed. 1) There were 20 cases of n+ group (7.8%). 2) There were 12 cases of depressed type early cancers with metastasis to the regional nodes (depressed type n+ group), and 137 cases of the single depressed type early cancers without metastasis to the nodes (depressed type n- group). Statistical comparison between the depressed type n+ group and n- group disclosed that the maximum diameter of the lesion of the n+ group was longer than that of the n- group, and histological type of cancer of the n+ group was more undifferentiated than that of the n- group. Items of the depth of invasion and site of the lesion are not statistically significant at this time, however, close attention should be paid to these items.