Ⅰ型早期胃癌手術後7年11ヵ月で再発死亡した1例―早期胃癌切除後5年以上経過再発死亡例の検討

Early Gastric Cancer, Type I Who Was Died of Local Recurrence of Carcinoma Seven Years and 11 Months after Gastrectomy, Report of a Case

要旨　早期胃癌で切除後5年以上経過再発例が7例ある．これは同期間の全早期胃癌切除例634症例の1.1％に当たる．全例が男性であり，再発形式は局所再発4例，リンパ行性広範再発2例，肺転移1例であった．組織型では分化型腺癌が6例，深達度ではsmが6例であった．この中の代表的な43歳，男性，Ⅰ型早期胃癌手術後7年11カ月で再発死亡した症例を呈示した．以上のように，早期胃癌長期経過再発例には局所再発が多いことから，これらの手術に際しては早期胃癌と言えども，十分なリンパ節郭清を含めた根治手術の必要性を再認識した．

　In 7 (1.1%) of 634 cases of early gastric cancer which had been operated on more than 5 years ago, a later recurrence of cancer have been proved in our Institute. All cases were male, in six cases well differentiated adenocarcinoma and its invasion into the submucosa was confirmed. Patterns of the recurrence were local in four cases, widely lymphatic spread in two cases and lung metastasis in one case.

　The typical case of 43 years old man with Ⅰ type of early gastric cancer who died of a local recurrence of carcinoma seven years and 11 months after gas-trectomy was demonstrated.

　From these results, it must be emphasized that a sufficient removal of the lymph nodes around the stomach is essential in the first operation of early cancer.