clinicopathologicar Study on Advanced Gastric Cancer Diagnosed as Early Cancer before Operation

Tokihiro Yoshikawa, Masatsugu Kitamura, Kuniyoshi Arai

Department of Surgery, Tokyo Metropolitan Komagome Hospital

Eighty-seven cases of advanced gastric cancer diagnosed as early gastric cancer before surgery were studied to determine the indication of limited lymph node dissection for early gastric cancer. Most of the tumor of advanced gastric cancer diagnosed as early cancer were macroscopically depressed type and undifferentiated carcinoma histologically. About half of these cancers was diagnosed as advanced cancer only by histological examination. But the outcome for the patients with these cancers was relatively good, similar to that for patients with early gastric cancer. Lymph node metastasis was rare in the patients with differentiated carcinoma diagnosed as mucosal cancer before surgery, even though the depth of the cancer invasion was proved to be beyond the submucosal layer histologically. Limited lymph node dissection (R₁-operation) for the patients with early gastric cancer keeps up an operative radicality, even in the presence of advanced cancer diagnosed as early cancer, if that operation is indicated only for the patients with differetiated carcinoma diagnosed as mucosal cancer before surgery.

Key words
gastric cancer, early gastric cancer, limited lymph node dissection, preoperative diagnosis of gastric cancer

Reprint requests
Tokihiro Yoshikawa Department of Surgery, Chuo Sogo Hospital
2-1-5 Fukuzumi, Nagaoka, 940 JAPAN

Accepted
April 11, 1990

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