Abstract
We have performed D2 lymph node dissection in 520 cases of mucosal confined gastric cancer in a recent 23 year period. In the series we experienced no recurrent cases. Thus limited operation for mucosal cancers is feasible, because of its infrequent lymph node involvement. We studied these 520 cases with regard to lymph node metastases to elucidate a criteria for limited operation, especially for endoscopic mucosal resection (EMR). Twelve cases had lymph node metastases. Overall metastatic rate was 2.1%. The rate of lymph node metastases were high in woman, ly(+) and ul(+) cases, with significant differences. Histologic types had no impact on the metastatic rate. Elevated tumors less than 20mm in diameter and depressed tumors less than 15mm did not involve lymph nodes. Also tumors located in the region C, flat tumors and mixed type tumors were metastasis free. In conclusion, our results justify the general indication of EMR.
