Diagnostische und therapeutische Aspekte des Magenfrühkarzinoms

Among 947 patients operated on for gastric carcinoma between 1961 and 1976 there were 60 with early (superficial) gastric carcinoma. All but two patients consulted their doctor for diverse complaints. In one third of them treatment was delayed for a year or longer. In 26 of the 64 cancer foci it was limited to the mucosa. The correct diagnosis was made radiologically in 60%, gastroscopically in 70%. Selective endoscopic biopsy increased accuracy to 90%. The remaining false-negative findings occurred in the ulcerative form, which was the most frequent one. Improved radiological techniques (double-contrast) and obligatory gastroscopy with biopsy increased the relative proportion of early (superficial) carcinoma from under 4% in 1961 to 15%. The diagnosis of this type of carcinoma can be made only by careful histological study of the surgical specimens. Here as elsewhere in the surgery of carcinoma, multicentricity (in 5%) and possible lymph node metastases (10-20%) must be taken consideration in the surgical management.