Limited Surgery for Early Cancer in the Middle Part of the Stomach-A Retrospective Study Based on Lymph Node Metastasis-

Susumu Ohwada, Yoshiyuki Kawashima, Masaru Izumi, Junya Kobayashi, Masaaki Arai, Isao Kobayashi, Yoshihiro Sato, Tetsushi Ogawa, Seiji Nakamura, Yasuo Morishita

The Second Department of Surgery, Gunma University School of Medicine

The status of lymph node metastasis according to clinicopathological factors such as macroscopic type, tumor size, histologic type and depth of cancer invasion was evaluated in 144 patients with solitary early cancer in the middle part of the stomach who were undergoing resection. Lymph node metastases were observed in six patients, 4.2% (one in mucosal and five in submucosal cancer). No lymph node metastasis was found in mucosal cancer of less than 5.0 cm in diameter. Lymph node metastasis was noted in submucosal cancer with massive invasion to the submucosal layer, macroscopic elevated and depressed types, cancers more than 5.1 cm in diameter or poorly differentiated adenocarcinoma. Therefore, segmental gastrectomy and lymph node dissection of first group nodes including No. 7 of the second group nodes may be suitable for 1) all mucosal cancers, 2) submucosal cancers, cancers less than 5.0 cm in diameter, macroscopically elevated or depressed types or differentiated adenocarcinoma. Moreover, it is necessary to select standard surgery for submucosal cancer that is more than 5.1 cm in diameter, elevated and depressed types or poorly differentiated adenocarcinoma.

Key words
early cancer in the middle part of stomach, limited surgery for early cancer in the middle part of stomac, lymph node metastasis of early gastric cancer, segmental gastrectomy

Reprint requests
Susumu Ohwada The Second Department of Surgery, Gunma University School of Medicine
3-39-15 Showa-machi, Maebashi, Gunma, 371 JAPAN

Accepted
January 11, 1995

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