[Early gastric and superficial muscle gastric cancer. Contribution of morphology to prognosis].

The purpose of the study was to correlate the depth of invasion in the gastric wall with survival in gastric cancer. In order to do so, we reviewed 48 patients harboring 58 gastric adenocarcinomas that did not exceed the superficial half of the muscularis propia. The patients were followed for up to a period of a least 5 years after surgery. The depth of invasion of the tumour in the gastric wall was found to correlate significantly with the invasion of lymphatic capillaries (p < 0.001) and with the finding of lymph node metastasis (mucous cancer 9%, submucous cancer 36% and superficial muscularis propia cancer 40%; p < 0.05). The size of the tumour was directly related with the depth of the cancerous invasion. Survival after 5 years varies significantly according to size of tumour (< 2 cm = 100%, 2-5 cm = 86% and > 5 cm = 33%; p < 0.0001), invasion of lymphatic capillaries (p < 0.01) and depth of the cancerous invasion (mucous cancer 94%, submucous cancer 84% and superficial muscularis propia cancer 67%; p < 0.05). The Lauren diffuse type or the multicentric cancer had a worse prognosis. The depth of invasion in the gastric wall appears to be the most important prognostic factor, since both the size of the tumor and the lymphatic involvement are related to it. When the tumour is limited to the muscularis propia, the survival rate is intermediate between early gastric cancer and advanced cancer.