[The potentials for the organ-preserving treatment of early stomach cancer].
The oncological substantiation of endoscopic and economical surgical treatment of T1N0-1M0 gastric carcinoma in 46 patients was appraised. The results were studied with due regard for the peculiarities of early gastric carcinoma (EGC) revealed in 290 patients after standard surgical management. It was established that organ-preserving treatment of ECG is possible--5-years survival was 96.2%. Endoscopic removal can be considered radical only in T1P1 tumors without invasion of the lymphatic vessels of the wall and was of a multistage character in 86.2% of cases. Careful surveillance after its completion is necessary. Surgical treatment in indicated in repeated recurrences; they were encountered in 44.8% of cases. The causes of the recurrences were noncoincidence of the macroscopic and histological boundaries of the tumor (33.6%), multicentric growth (30.4%), and invasion of the submucosa. Metastases are encountered in the lymph nodes in 9.1% of cases in economical treatment. In T1N0-1M0P1-2 carcinoma, absence of multicentric growth, and III degree dysplasia in the surrounding mucosa (reflecting increased risk of multicentric growth) the volume of organ resection may be limited on condition that P1 lymphadenectomy is performed. The results of organ-preserving treatment are comparable with those of surgical treatment conducted in a standard volume.
Chissov
V I
VI
Vashakmadze
L A
LA
Averbakh
A M
AM
Stakhanov
M L
ML
Frank
G A
GA
Belous
T A
TA
D000236:Adenoma / Q000473:pathology / Q000601:surgery; D004564:Electrocoagulation; D005260:Female; D005743:Gastrectomy; D005773:Gastroscopy; D006801:Humans; D053685:Laser Therapy; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000473:pathology; D009367:Neoplasm Staging; D011127:Polyps / Q000473:pathology / Q000601:surgery; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D013997:Time Factors
Vozmozhnosti organosokhraniaiushchego lecheniia rannego raka zheludka.