Clinicopathological features of mucosal carcinoma of the stomach with lymph node metastasis in eleven patients

Korenaga, Daisuke; Haraguchi, Masanobu; Tsujitani, Shunichi; Okamura, Tomonori; Tamada, Ryuichiro; Sugimachi, Keizō

doi:10.1002/bjs.1800730605

Cited by 87 publications

(47 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is well established that, as the depth of gastric carcinoma invasion into the gastric wall increases, the frequency and the degree of nodal metastasis also increases. Lymph nodal metastasis is present in 1.8-4.8% of EGC patients with mucosal invasion, but in 16.7-23.8% of those with submucosal invasion (Habu et al, 1986;Korenaga et al, 1986;Ohta et al, 1987;Iriyama et al, 1989;Sowa et al, 1989;Inoue et al, 1991;Moreaux and Bougaran, 1993). Thus, the local invasiveness of EGC may be correlated with the survival rate (Lawrence and Shiu, 1991).…”

Section: Survivalmentioning

confidence: 99%

“…Numerous clinicopathological studies have demonstrated that the frequency of nodal metastasis in EGC with mucosal invasion is less than 5%. The degree of nodal invasion is almost always limited to nl(+), and in less than 1% of the cases with n2( +) (Habu et al, 1986;Korenaga et al, 1986). EGC patients with n2( +) would have been cured only by the ELND procedure but this would have resulted in a comparatively small improvement in the survival rate.…”

Section: Survivalmentioning

confidence: 99%

“…It is not rare for a tumour that has been grossly diagnosed as mucosal carcinoma to infiltrate into the submucosal layer or deeper. We know for certain that the protruded type EGC less than 2.0 cm in diameter is limited to the mucosa and that it lacks nodal metastasis (Kitaoka et al, 1984;Korenaga et al, 1986;Ohta et al, 1987;Iriyama et al, 1989). In addition, if a tumour shows a depressed differentiated adenocarcinoma less than 1.0cm in diameter, then it has little chance of nodal metastasis (Takekoshi et al, 1994).…”

Section: Survivalmentioning

confidence: 99%

See 2 more Smart Citations

Rationale for extensive lymphadenectomy in early gastric carcinoma

Miwa

Miyazaki²,

Sahara³

et al. 1995

Br J Cancer

View full text Add to dashboard Cite

Summary The incidence of nodal metastasis in early gastric carcinoma (EGC) is 10-20%. However, the optimal nodal dissection for early gastric carcinoma has not been established. A retrospective study was conducted in 392 consecutive patients who underwent potentially curative distal gastrectomy for EGC between 1962 and 1990. Of these 295 patients treated after September 1972 were prospectively entered into an extensive lymphadenectomy protocol. These patients were compared with 97 patients with simple gastrectomy in respect of the causes of death after surgery and the 10 year disease-specific survival rate. The incidence of nodal metastasis in early gastric carcinoma patients was 13.0%. Operative mortality from extensive lymphadenectomy was almost the same as from simple gastrectomy (2.0% and 2.1% respectively). Extensive al., 1987; Ohta et al., 1987; Marczel et al., 1988;Lehnert et al., 1989;Percivale et al., 1989;Farley et al., 1992;Maehara et al., 1993). Nevertheless, the optimal extent of lymph node dissection for EGC has not been well established. Japanese surgeons normally perform extensive lymphadenectomy for EGC because a certain proportion of these patients have lymph nodal involvement and carcinoma recurrence is not rare. In contrast, most surgeons in Western countries do not use aggressive surgery (Cuschieri, 1986;Heberer et al., 1988;Irvin and Bridger, 1988;Heesakkers et al., 1994), perhaps because of uncertainty regarding improvement in the survival rate and the high operative risk associated with extensive lymph node dissection (Dent et al., 1988;Heberer et al., 1988;Irvin and Bridger, 1988).To evaluate the therapeutic value of extensive lymphadenectomy in EGC, we analysed retrospectively the causes of death after surgery and compared the 10 year disease-specific survival rate in patients who had received extensive lymphadenectomy with patients who had received simple gastric resection. (LLND). ELND was performed beginning in September 1972. The LLND group consisted of 68 patients before September 1972 and 29 patients after. Each surgical procedure is outlined below. The subjects were followed up, and the effect of lymph node dissection on their 10 year disease-specific survival was evaluated. The operative and pathological findings were assessed according to the guidelines of the Japanese Research Society for Gastric Cancer (1981). The median age of the patients at the time of operation was 59 years, with a range of 18-84 years. There were 271 males (69%) and 121 females (31%). SurgeryThe ELND gastrectomy was performed as follows: the entire greater omentum, superior leaf of the mesocolon, pancreatic capsule and lesser omentum were removed en bloc with the cancerous distal portion of the stomach. Each of the supplying gastric arteries was ligated and divided at its origin, and the group 1 lymph nodes (nl), namely those along the lesser and greater curvatures, as well as the supra-and infra-pyloric lymph nodes, were completely dissected. In addition, the group 2 lymph nodes (n2) located at the...

show abstract

Section: Survivalmentioning

confidence: 99%

Section: Survivalmentioning

confidence: 99%

Section: Survivalmentioning

confidence: 99%

See 1 more Smart Citation

Rationale for extensive lymphadenectomy in early gastric carcinoma

Miwa

Miyazaki²,

Sahara³

et al. 1995

Br J Cancer

View full text Add to dashboard Cite

show abstract

“…In intramucosal cancers, lymph node metastasis was reported to be much less frequent, ranging from 1.9-3.3 %, compared to those in submucosal cancers, about 16.3-20.9 % [11][12][13][14][15]23]. A number of studies reported the incidence of lymphatic involvement in intramucosal cancers and cancers that involved submucosal invasion altogether.…”

Section: Discussionmentioning

confidence: 99%

Incidence of lymphatic involvement in differentiated-type intramucosal gastric cancers as examined by endoscopic resection

et al. 2015

View full text Add to dashboard Cite

Background Lymphatic involvement may sometimes be detected in differentiated-type intramucosal cancer resected endoscopically during routine examination, but its incidence and clinical significance remain unknown. Methods We examined 300 endoscopically resected lesions obtained from 238 patients diagnosed with differentiated-type intramucosal gastric cancer. All sections were subjected to D2-40 monoclonal-based immunohistochemistry. Results The incidence of lymphatic involvement in differentiated-type intramucosal cancer was 2.0 % (6/300). An incidence of 1.8 % (5/279) was determined in lesions that were B3 cm in size and 2.2 % (6/276) in those without an ulcer or ulcer scar. Of the six lesions presenting lymphatic involvement, three were determined to be histologically mixed with a predominance of differentiated type, while the other three lesions were pure differentiated type. Conclusions We determined that the incidence of lymphatic involvement in differentiated-type intramucosal cancer was 2.0 %. To clarify the clinical significance of such lymphatic involvement, it is necessary to detect it with this incidence in mind and to gather and follow up the clinical courses of such cases.

show abstract

“…This technique allows enbloc resection of the lesions (1) which has demonstrated to be crucial because the local recurrence rate when this is not possible is of 15 % (2). Nowadays, there is a high experience with ESD in Eastern countries where this technique is considered the gold standard treatment for EGC (3,4).…”

Section: Introductionmentioning

confidence: 99%