Limited Surgery for Early Cancer in the Middle Part of the Stomach

A Retmspective Study Based on Lymph Node Metastasis

Abstract

The status of lymph node metastasis according to clinicopathological factors such as macroscopic type, tumor size, histologic type and depth of cancer invasion was evaluated in 144 patients with solitary early cancer in the middle part of the stomach who were undergoing resection. Lymph node metastases were observed in six patients, 4.2% (one in mucosal and five in submucosal cancer). No lymph node metastasis was found in mucosal cancer of less than 5.0cm in diameter. Lymph node metastasis was noted in submucosal cancer with massive invasion to the submucosal layer, macroscopic elevated and depressed types, cancers more than 5.1cm in diameter or poorly differentiated adenocarcinoma. Therefore, segmental gastrectomy and lymph node dissection of first group nodes including No.7 of the second group nodes may be suitable for 1) all mucosal cancers, 2) submucosal cancers, cancers less than 5.0cm in diameter, macroscopically elevated or depressed types or differentiated adenocarcinoma. Moreover, it is necessary to select standard surgery for submucosal cancer that is more than 5.1cm in diameter, elevated and depressed types or poorly differentiated adenocarcinoma.