Clinicopathological Study of Gastric Mucosal Cancer with Lymph Node Metastasis

Shou Ishihara, Toshifusa Nakajima, Hirotoshi Ohta, Hirofumi Yamada, Keiichiro Ohta, Mitsumasa Nishi, Akio Yanagisawa, Yo Kato

Division of Surgery and Pathology, Cancer Institute Hospital

Lymph node metastasis is a very important issue when we perform endoscopic resection or a limited operation for early gastric cancer. The clinicopathological characteristics of mucosal cancer with lymph node metastasis were determined in 946 cases, in which the cancer had been resected in our hospital from 1966 to 1987. Ten of the patients had lymph node metastases at a rate of 1.1% of all cases. The clinicopathological characteristics of the high risk group in terms of lymph node metastasis are as follows: 1. Tumor size more than 4 cm. 2. Depressed type. 3. The tumor has an ulcer or an ulcer scar more than UI-II.. 4. Undifferentiated type. In other words, conditions in the high risk group are idential with those of the so-called "superficial spreading type of carcinoma". Therefore, as far as lymph node dissection is concerned, almost all gastric mucosal cancers are supposed to be treated by endoscopic resection or a limited operation. But now it is very difficult to make an accurate diagnosis of the depth "m" and "sm" before surgery, and its accurate diagnostic rate is still low. Therefore we should select the cases strictly for this therapy, and in particular we should pay attention to the cases of undiferentiated and depressed type with an ulcer or an ulcer scar of early gastric cancer.

Key words
gastric mucosal carcinoma, lymph node met astasis, limited operation for early gastric cancer, endoscopic resection for early gastric cancer

Reprint requests
Shou Ishihara Division of Surgery, Cancer Institute Hospital
1-37-1 Kamiikebukuro, Toshimaku, Tokyo, 170 JAPAN

Accepted
November 11, 1992

To read the PDF file you will need Abobe Reader installed on your computer.