Abstract
The indication of omitting the No.1, 5 and 6 lymph node dissection for the early gastric cancer of the M region was examined. The subjects consisted of 378 cases of single gastric cancer of the M region (early stage 199 cases, advanced stage 179 cases) and a total 230 cases of m cancer in the same period. In the M region, metastasis in the lymph node was observed in 2.9% (3/105) of m cancer, all of which were undifferentiated IIc type with Ul (+). There were 2 cases (1.9%) of metastasis in the No.1 lymph node but no metastasis was found in the No.5 nor 6. In 94 cases of sm cancer, 1 case (1.1%) of metastasis was seen in the No.1, and 3 cases (3.2%) of metastasis in the No.5 and 6. In 125 cases of m cancer of other area, 2 cases of metastasis in the lymph node were seen in the depressed type with Ul (+). In 146 cases of the depressed m cancer, rate for metastasis in the lymph node was 1.2% (1/75) for differentiated type and 5.6% (4/71) for undifferentiated type. In relation to Ul, that rate was 0.0% (0/68) for Ul (-) and 6.4% (5/78) for Ul (+). No metastasis was observed in the tub1, Ul (-). tub2 and undifferentiated type with Ul (-). Furthermore, the relation between the metastasis and diameter of the carcinoma was examined and the following M localized m cancer was considered as a candidate for omission of No.5 and 6 lymph nodedissection; elevated type of 5.0cm diameter or less; as for depressed type (IIc) of tub1 of 4.5 cm or less, Ul (-). tub2 of 4.0 cm or less and undifferentiated Ul (-) of less than 1.0cm diameter. From additional examination, it was determined that there was a possibility to omit the dissection of No.1 and 5 lymph node in the m gastric cancer that is located in the greater curvature.
