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Four hundred and fourteen cases of early gastric cancer (EGC), diagnosed between 1977 and 1993, were studied. The percentage of EGC increased from 1977 to 1984, but thereafter remained more or less stable, despite a continuous increase in the number of endoscopic examinations. Three hundred and ninety-six patients were followed up. Twenty-nine patients died from the tumour, giving a 5-year survival rate of 82.8 per cent. The 'large' size type of EGC, the presence of submucosal penetration, and lymph-node metastasis showed a highly significant association with a lower survival rate. A small number of patients died despite the presence of 'favourable' prognostic factors. Other still unknown factors may therefore be important in determining the aggressive behaviour of certain EGCs.
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