Early gastric cancer

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Abstract
Sixteen patients with early gastric cancer (carcinoma which is confined to mucosa and submucosa) are described. Despite a long duration of symptoms and frequently large tumour surface areas, lymph‐node metastasis occurred in only one patient. Findings of endoscopic biopsy were more accurate (100%) than endoscopic (75%), radiological (50%), or clinical features in diagnosing malignancy. However, only an average of 58% of biopsy specimens demonstrated cancer, which emphasises the need for multiple biopsies. After resection, no deaths due to cancer occurred during a mean follow‐up period of 28 months. Endoscopy, plus carefully directed biopsy when a lesion is found, should be performed in patients with dyspepsia in whom X‐ray examination reveals no abnormality, and in those with persistent symptoms in the upper gastrointestinal tract. Such an approach is a prerequisite to the accurate diagnosis of gastric cancer in its early, curable, stage.