Clinical Usefulness and Problem in Subclassification of Early Gastric Cancer with Submucosal Invasion

Sumiya Ishigami, Shuichi Hokita, Kuniaki Aridome, Teruhiko Watanabe, Futoshi Miyazono, Koki Tokuda, Akihiro Nakajo, Hiroshi Higashi, Shoji Natsugoe and Takashi Aikou

First Department of Surgery, Kagoshima University School of Medicine

We studied the clinical efficacy of subclassifying early gastric cancer invading the submucosa based on the General Rules of Gastric Cancer. Of 120 patients, 50 were classified with SM1 cancer and the other 70 with SM2. The incidence of lymph node metastasis in SM2 patients was significantly higher than that in SM1 patients. SM1 patients had 13% nodal involvement, higher than that in conventional SM1 patients Although confined to tumors lass than 2 cm in size, no patient had lymph node metastasis. Submucosa was from 1,270 μm thick in lesser curvature of the antrum to 1,890 μm, depending on tumor location. Five of SM1 patients with nodal involvement had a lower third or lesser stomach curvature. For tumors lass than 2 cm, subclassification of early gastric cancer invading the submucosa is suitable for predicting nodal involvement. Tumor location must therefore be considered when evaluating submucosal tumor invasion.

Key words
subclassification, submucosal layer, early gastric cancer

Reprint requests
Sumiya Ishigami First Department of Surgery, Kagoshima University School of Medicine 8-35-1 Sakuragaoka, Kagoshima, 890-0075 JAPAN

Accepted
January 31, 2001

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