Clinical and pathological features of early gastric cancer in Singapore

Abstract

Objective: The incidence of early gastric cancer (EGC) is increasing gradually in countries such as Japan and Korea. Knowledge of EGC in other Asian countries, however, is limited. This study aims to describe the characteristics of this disease in Singapore. Method: A retrospective analysis of the operative results of a personal series of EGC was undertaken. The clinical and pathological characteristics were examined. Results: From 1979 to 1997, 226 patients with gastric cancer were operated on and 21 patients (9.3%) were diagnosed as having EGC by histological examination. All 21 patients received radical gastrectomy and lymphadenectomy. There were 12 males and 9 females with a median age of 59 years (range: 36-65). The presenting symptom was epigastric pain (15 patients), bleeding (two patients), weight loss (two patients), vomiting and incidental (one patient each). The majority of the tumours (76%) were located at the antrum and were intestinal type. Macroscopically, most of the tumours were either depressed (type IIc) or excavated (type III) type. Four cases were combined type. The lesion was limited to the mucosa in 10 cases. Only one patient had lymph node metastasis. There was no operative mortality and the morbidity rate was 14%. Nineteen patients had complete follow up for 3 months to 13 years. No patient developed tumour recurrence in the series. Conclusion: Early gastric cancer remains uncommon in Singapore. However, for these patients, radical gastrectomy yields excellent results with minimal morbidity.