Clinicopathological Study of Gastric Mucosal Cancer with Lymph Node Metastasis

• Published in: Nippon Shokaki Geka Gakkai zasshi Vol. 26; no. 3; pp. 796 - 802
• Main Authors: Ishihara, Shou, Nakajima, Toshifusa, Ohta, Hirotoshi, Yamada, Hirofumi, Ohta, Keiichiro, Nishi, Mitsumasa, Yanagisawa, Akio, Kato, Yo
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society of Gastroenterological Surgery 1993
• Subjects: astric mucosal carcinoma; endoscopic resection for early gastric cancer; limited operation for early gastriccancer; lymph node met astasis
• ISSN: 0386-9768; 1348-9372
• DOI: 10.5833/jjgs.26.796

Lymph node metastasis is a very important issue when we perform endoscopic resection or a limited operationfor early gastric cancer. The clinicopathological characteristics of mucosal cancer with lymph node metastasiswere determined in 946 cases, in which the cancer had been resected in our hospital from 1966 to 1987. Ten of thepatients had lymph node metastases at a rate of 1.1% of all cases. Theclinicopathological characteristics of the highrisk group in terms of lymph nodemetastasis are as follows: 1. Tumor size more than 4 cm. 2. Depressed type. 3.The tumor has an ulcer or an ulcer scar more than UI-11.4. Undifferentiated type.In other words, conditions in thehigh risk group are idential with those of the so-called “superficial spreading type of carcinoma”. Therefore, as faras lymphnode dissection is concerned, almost all gastric mucosal cancers are supposed tobetreated by endoscopicresection or a limited operation. But now it is very difficult to make an accurate diagnosis of the depth “m”and “sm”beforesurgery, andits accurate diagnostic rate is still low. Therefbre we should select the cases strictly for this therapy, and in particular we should pay attention to the cases ofundiferentiated and depressed type with anulcer or an ulcer scar of early gastric cancer.