Clinicopathological characteristics of superficial spreading type early gastric cancer.
OBJECTIVE
Superficial spreading type early gastric cancer is characterized by its atypical growth pattern and occasionally indistinct tumor margin. Because it is a rare form of early gastric cancer, the clinicopathological details are not apparent. The aim of this study was to clarify the clinicopathological features of the superficial spreading type of early gastric cancer.


METHODS
A retrospective study was conducted in 1,062 surgically resected patients with early gastric cancer. Hospital records were compared between patients with superficial spreading type early gastric cancer and those with more common types of early gastric cancer.


RESULTS
Sixty-nine patients (6.9%) had superficial spreading lesions. The male to female ratio was 1.2:1. The most frequent histological type was signet-ring cell carcinoma (32%). The distinguishing histopathological features were submucosal invasion (67%), lymphatic invasion (32%), and lymph node metastasis (30%). There were discrepancies in tumor area between surgical findings and pathological diagnosis in 24 patients (35%) with superficial spreading type. More extensive lymph node dissection was performed and all patients survived in the group with superficial spreading lesions.


CONCLUSIONS
The most appropriate treatment for the superficial spreading type of early gastric cancer is wide surgical resection with extensive lymph node dissection.
Imai
Masato
M
Department of Surgery, Sapporo Kosei General Hospital, Sapporo, Japan.
Kondo
Yukifumi
Y
Osawa
Shohei
S
Nishida
Yasunori
Y
Okada
Kuniaki
K
Ishizu
Hiroyuki
H
Masuko
Hiroyuki
H
Hata
Tsunetake
T
Uemura
Kazuhito
K
Kina
Masaya
M
Honda
Shohei
S
Ishiyama
Gentaro
G
Takahashi
Toru
T
Hino
Atsushi
A
D005260:Female; D005743:Gastrectomy; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery*; D016019:Survival Analysis