Can PEN A Type Early Gastric Cancer be Considered as Advanced Cancer?

Although early Gastric Cancer (EGC) generally has a very good prognosis, this is not the case for a subset of patients defined as PEN A type according to Kodama’s microscopic classification. In 530 patients operated on in our surgical department between 1976-2006, the EGC survival rate was 94%. The 5-year survival of Pen A patients was 83%, decreasing to 69.7% when there was lymph node involvement. Moreover, survival rates for PEN A patients continued to decrease with respect to other EGC types (10-year survival 73% vs. 94%, respectively). PEN A EGC should thus be considered as advanced cancer.