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Stomach and Intestine(Tokyo) Volume 7, Issue 4 （April 1972）

胃と腸 7巻4号（1972年4月発行）

Japanese English

今月の主題早期胃癌肉眼分類起草10年

早期胃癌の治療成績 End Results of Early Gastric Cancer 三輪潔 ¹ , 伊藤一二 ¹ , 渡辺弘 ¹ , 平田克巳 ¹ , 北岡久三 ¹ , 吉川謙蔵 ¹ , 矢島睦夫 ¹ K. Miwa ¹ , I. Ito ¹ , H. Watanabe ¹ , K. Hirata ¹ , K. Kitaoka ¹ ¹国立がんセンター外科 ¹Dept. of Surgery, National Cancer Center Hospital pp.481-488

発行日 1972年4月25日 Published Date 1972/4/25

DOI https://doi.org/10.11477/mf.1403109090

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Abstract 文献概要
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　胃のレ線診断，内視鏡診断，細胞診ならびに胃生検の飛躍的進歩によって，胃癌の早期診断は，1960年を境に着々と実績を挙げつつある．早期胃癌とは，癌の浸潤が胃の粘膜（m）または粘膜下層（sm）にとどまるものということが，胃癌研究会において統一定義されたのも，このような早期診断の進歩のもたらした結果といえよう．

　早期胃癌の治療成績は，5年生存率で90％を越すという報告が，すでに多くの施設から報告されている．内視鏡学会において，東大分院の林田の行なった全国集計では，深達度mの早期胃癌では，184例中の5年生存例は174例で，5年生存率は94.6％，深達度smの早期胃癌では，167例中5年生存例146例，5年生存率は86.8％，早期胃癌全体の5年生存率は91.1％となっている．

　Of 1,042 primary cases of gastric cancer admitted to the National Cancer Center from May 1962 to August 1966, we came across 159 cases of early gastric cancer with depth invasion confined to the mucosa (m) or to submucosa (sm). They account for 14.6 per cent of all gastric cancer cases in our series. Direct death from operation was seen in 2 cases, and its rate for early gastric cancer was 1.3 per cent, while for all resected gastric cancer cases it was 5.0 per cent.

　The five-year-survival rate of all gastric cancer cases in our series was 32.2 per cent, and for cases of curative resection it was 60.2 per cent. Excepting cases of direct death from operation or those died from causes other than cancer, the five-year-survival rate for curative resection cases of early gastric cancer achieved a very high percentage. Indeed, in 69 cases with only mucosal involvement, no one died of recurrence, so that the rate is 100 per cent. On the other hand, in those with sm degree of cancer invasion, 8 out of 73 cases succumbed from recurrence, and the five-year-survival rate for this group dropped to 89.0 per cent. The overall five-year-survival rate of early gastric cancer as a whole was 94.4 per cent.

　According to the studies of various factors affecting prognosis of early gastric cancer, the prognosis of the cases with sm invasion, lymph node metastasis, and unassociated ulcer and also cases of papillary or well differentiated adenocarcinoma is very disappointing. Of 9 of those satisfying all these conditions, 4 died of recurrence within 5 years after surgical operation. The rate of death from recurrence in this group was thus 44.4 per cent. Early gastric cancer of this type was either of protruding type or of surface-elevated type.