Clinical and pathological evaluation of early gastric cancer and lymph node metastasis.

Abstract

Four hundred fifty-nine solitary early gastric cancers were studied, retrospectively. There were 313 men and 146 women. The proportion for solitary early gastric cancer of the total gastric cancers was 23.4 % (459/1960). Early cancers were grossly divided into three fundamental types. One hundred nine cancers (23.7 %) were the elevated type, 8 cancers (1.7 %) were the flat type, and the depressed type was the most frequent, present in 342 of the patients (74.5 %). Early cancers were also divided into two groups based on the depth of cancer invasion. Cancers confined to the mucosa, m-cancers, were observed in 220 patients (47.9 %), whereas cancers invading the submucosa, sm-cancers, were seen in 239 patients (52.1 %). On microscopic examination, 329 cancers (71.7 %) were the differentiated type and the remaining 130 cancers (28.3 %) were the undifferentiated type. Positive lymph node metastases were noted in 48 of 459 patients, which is a lymph node metastasis rate of 10.4 %. With m-cancers, only 4.1 % (9/220) had lymph node metastases. On the other hand, in sm-cancers, 16.3 % (39/139) had lymph node metastases (P<0.001). The 5-year and 10-year survival rates were 96.8 % and 96.8 % in m-cancer, and 94.8 % and 90.1 % in sm-cancers. The survival rates for differentiated land undifferentiated types of cancers were not significantly different.

Clinical and pathological evaluation of early cancer in the gastric cardia.

“…The incidence of early gastric cancers has increased to about 50% of gastric cancers in Japan recently (Takeda et al 1987), as compared with about 10-15% in Europe (Borchard, 1990). However, the detection rate of early cardia cancer is still low, being only 11.7 % in our pre-sent study and 15.6% in a study by Okamura et al (1987).…”

Early Gastric Cancer with Juxta Regional Lymph Node Matastases.

“…R2-gastric resection which involves gastrectomy, omentectomy and the complete removal of Groups 1 and 2 regional lymph nodes has been gererally accepted as the procedure of choice for the treatment of EGC. As a result, surgical treatment for EGC patients has achieved an excellent 5 year survival rate of about 97% (Kitaoka et al 1984;Takeda et al 1987). Habu et al (1986) reported that cancer recurrences occurred more often in patients who had undergone no lymph node dissection (9.4%) than in those who had undergone lymph node dissection (1.5 °o) .…”

Early Mucosal Gastric Cancer with Extra-Perigastric (n2) Lymph Node Metastasis.

“…However, the lymph node metastasis rate in m -cancer was low, 3-5% has been reported (Fu jita et al 1983;Takeda et al 1987), and metastases were mainly observed in the Group 1 lymph nodes in a previous study (Takeda et al 1987).…”