title: Surgical outcome in superficially spreading early gastric cancer.
abstract: OBJECTIVE
  Superficially spreading early gastric cancer is characterized by wide horizontal extension without deep vertical invasion. This study aimed to clarify the clinicopathological characteristics and prognosis of this rare disease.
  
  
  METHODS
  We defined superficially spreading early gastric cancer as any tumor invading the submucosal layer that measured > or =60 mm in diameter. The clinicopathological characteristics and results of surgery were compared between 60 patients with superficially spreading tumors and 621 patients with the common type (<60 mm in diameter).
  
  
  RESULTS
  For superficially spreading cancers,significantly higher numbers of female patients, undifferentiated and scirrhous types, infiltrating growth and lymph node metastases were seen. The number of metastatic lymph nodes was greater than in the common type. There was no significant difference in the distribution of metastatic lymph nodes between the two groups. For superficially spreading tumors, wide gastrectomy with extended lymph node dissection was frequently employed. Lymph node metastasis, but not tumor diameter, was a prognostic factor in uni- and multivariate analyses.
  
  
  CONCLUSIONS
  Although superficially spreading early gastric cancer has histologically distinct properties, gastrectomy with lymph node dissection with sufficient surgical margin could be a suitable treatment.
authors.affiliation: Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan. s0714@med.yokohama-cu.ac.jp
authors.forename: Chikara
authors.initials: C
authors.lastname: Kunisaki
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Akiyama
authors.forename: Masato
authors.initials: M
authors.lastname: Nomura
authors.forename: Goro
authors.initials: G
authors.lastname: Matsuda
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Otsuka
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Ono
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shimada
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D005260:Female; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery*; D016019:Survival Analysis; D016896:Treatment Outcome