Rational Lymph Node Dissection for Early Cancer in the Lower Part of Stomach -Indication for the Omission of No. 1, 3, 4sb, 5 and No. 7 Lymph Node Dissection-

Hidetoshi Suzuki, Setsuo Akaishi, Takashi Itoh, Toshiaki Baba, Mitsuhiro Mikami, Toyoaki Sasaki, Yasunori Mikami, Yuzuru Sugiyama, Kageyoshi Seino, Masaaki Endoh, Mutsuo Sasaki, Mitsuru Konn

Second Department of Surgery, Hirosaki University School of Medicine

Indications for omitting dissection of lymph nodes 1, 3, 4sb 5 and 7 in early gastric cancer of the A region were studied in 412 cases of resected cancer of the A region (early 188, advanced 224) and 443 cases of early gastric cancer (m 231, sm 212). All in 25 cases of cancer in the A region with metastases to lymph nodes 1 and 4sb were at ss or beyond in depth and over 5 cm in diameter. Metastases were absent in lymph nodes 3,5 and 7 in m cancer and in patients with lesions under 3 cm on the greater curvature. Review of all m cancers showed that 5 cases with metastases were Ul (+) and depressed, and the only differentiated lesion with metastasis was a IIc + III⋅tub₂ cancer. Among sm cancers, metastases were absent in elevated lesions under 1.8 cm and carcinomas under 1 cm. These findings suggest that dissection of lymph nodes 1 and 4sb may be omitted for elevated cancer under 5 cm, U1 (-) and U1 (+)⋅tub₁ , IIc m cancer, elevated sm cancer under 1.8 cm and sm cancer under 1 cm. With lesion on the greater curvature, the indications include sm cancer under 3 cm too, and dissection of lymph nodes 3, 5 and 7 can be omitted for, Ul (-) and Ul (+) ⋅tub₁ IIc m cancer under 3 cm, and sm cancer under 1 cm, all in the A region.

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Hidetoshi Suzuki Second Department of Surgery, Hirosaki University School of Medicine
5 Zaifuchou, Hirosaki, 036 JAPAN

Accepted
October 11, 1995

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