[Clinicopathological study of early gastric cancer--indication of conservative surgery and radical endoscopic treatment of early gastric cancer].
Clinicopathological factors such as depth of cancer invasion, size, gross type, frequency of metastases to regional lymph nodes, and distant prognosis were evaluated in last consecutive 339 cases with solitary early gastric cancer. The conservative surgery, that is, subtotal gastrectomy with complete dissection of lymph nodes of group 1 and selective celiac group and partial bursectomy, would be indicated for early gastric cancers located in antrum or corpus. But if the metastasis to the group 2 lymph nodes is suspected during the surgery, it is necessary to dissect lymph nodes en bloc more than group 2. The results, concerning the type of early gastric cancer without lymph node metastasis and the indication of endoscopic treatment, were as follows; 1. Intramucosal cancer of elevated type less than 2 cm in diameter. 2. Intramucosal cancer of depressed type less than 1cm in diameter, without peptic ulcer within the lesion, and a differentiated tubular adenocarcinoma histologically. 3. Intramucosal cancer of flat type less than 2 cm in diameter. But it is difficult to detect the depth of cancer invasion and lymph node metastasis preoperatively. We would emphasize that endoscopic treatment should be indicated in the case for which surgical treatment is not indicated.
Nashimoto
A
A
First Department of Surgery, Niigata University School of Medicine, Japan.
Tanaka
S
S
Miyashita
K
K
Sasaki
K
K
Muto
T
T
Soga
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy / Q000379:methods; D005773:Gastroscopy; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery / Q000628:therapy