Clinicopathological features and medical management of early gastric cancer.
BACKGROUND
The detection of early gastric carcinoma (EGC) has increased worldwide due to advances in endoscopic techniques and equipment. The aim of the current study was to compare the clinicopathological findings of patients with and without lymph node metastasis.


METHODS
A total of 440 cases of early gastric carcinoma in patients who underwent surgical procedures between 1981 and 2002 at Kochi Medical School were studied.


RESULTS
Lymph node metastasis was observed in 38 patients (8.6%) with EGC. Multivariate analysis identified 4 independent risk factors of lymph node metastasis: (1) submucosal invasion; (2) tumor diameter greater than 3.5 cm; (3) the presence of vascular invasion; and (4) the presence of lymphatic permeation.


CONCLUSIONS
For patients with tumor size between 1 cm and 3.5 cm we would recommend endoscopic resection initially, with a consideration for additional surgical resection if microscopic vascular invasion or lymphatic permeation is demonstrated.
Okabayashi
Takehiro
T
Kochi Medical School, Kohasu-Okocho, Nankoku, 783-85050 Kochi, Japan.
Kobayashi
Michiya
M
Nishimori
Isao
I
Sugimoto
Takeki
T
Namikawa
Tsutomu
T
Onishi
Saburo
S
Hanazaki
Kazuhiro
K
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D007564:Japan; D010535:Laparoscopy / Q000379:methods; D016015:Logistic Models; D008197:Lymph Node Excision / Q000379:methods; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009367:Neoplasm Staging; D011336:Probability; D018570:Risk Assessment; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D016019:Survival Analysis; D016896:Treatment Outcome