Abstract
Sixty five cases of the early gastric carcinoma, diagnosed and treated in our clinic from May 1967 to April 1970, were studied as to the clinical picture, pathological findings of the resected stomach, especially on the presence of lymph-vascular invasion of the gastric wall, histological classification of the degree of the removed lymph nodes metastasis, and so on.
In an analysis of 65 cases of the early gastric carcinoma, 32 cases were the carcinoma of the stomach of which invasion was limited to the mucosa (m), and 33 cases were of the submucosal (sm) layer
An average of 16 nodes per patient was obtained at operation and the metastasis into regional lymph nodes was observed in nine patients (13.8%), in whom 7 patients cancer already infilted into the submucosal layer (21.2%). One patient had the metastasis to the removal lymph nodes of group 2, and another one had the metastasis to infrapyloric lymph node (No. 6) and to lymph node at root of the mesenterium (No. 14) : so-called Jumping Metastasis. On examining the invasion to lymph channels of the gastric wall, it was proved that lymphogenic metastasis was found in sixteen patients (48.5%) with “sm” cancer but negative with “m” cancer.
No significant difference was found in sex, age, histological type, extent of cancer and its location, size and solidity of the removed lymph node between cases with vascular invasion and lymph nodes metastasis and without ones lymph node metastasis.
The cases with lymph-vascular invasion following were found in IIa group (IIa, IIa+IIc type) remarkably more than in IIc type in macroscopic classification. This fact suggested that the occurrence of metastasis might be associated with the essential characteristic of the gastric carcinoma.
According to these results, the author would also emphasize that it is necessary to perform the R2 procedure in the operation of gastric cancer to remove the regional lymph nodes.
