Abstract
As the proportion of early gastric cancers (EGC) has been steadily increasing, modifications of the “radical lymphadenectomy” approach to stomach cancer have been attracting considerable attention; however, accurate pre- and intraoperative evaluations of tumor extent are essential for the successful application of this method. We examined the reliability of macroscopically diagnosing node involvement by reviewing the operative and pathological records of 522 patients with EGC. Of 59 patients histologically diagnosed as node-positive (n+), only 19 (32%) had been macroscopically diagnosed as node-positive (N+). In contrast, of 61 N+ patients, 42 (69 %) were in fact n-. Metastases from histologically diffuse type carcinomas were less accurately diagnosed than those from intestinal type tumors. In 44% of the false-positive (N+/n-) patients, the tumor had been preoperatively diagnosed as advanced, which seemed to have lead to intraoperative overdiagnosis. These results suggest that lymph node metastases from EGC cannot be reliably diagnosed during surgery. The indications for a modified radical operation should thus be decided according to preoperative tumor evaluation based on the depth of invasion.
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Itoh H, Oohata Y, Nakamura K, Nagata T, Mibu R, Nakayama F (1989) Complete 10-year postgastrectomy follow-up of early gastric cancer. Am J Surg 159:14–16
Kitaoka H, Yoshikawa K, Hirota T, Itabashi M (1984) Surgical treatment of early gastric cancer. Jpn J Clin Oncol 14:283–293
Okamura T, Tsujitani S, Korenaga D, Haraguchi M, Baba H, Hiramoto Y, Sugimachi K (1988) Lymphadenectomy for cure in patients with early gastric cancer and lymph node metastasis. Am J Surg 155:476–480
Fukutomi H, Sakita T (1984) Analysis of early gastric cancer cases collected from major hospitals and institutes in Japan. Jpn J Clin Oncol 14:169–179
Sano T, Kobori O, Muto T (1992) Lymph node metastasis from early gastric cancer: Endoscopic resection of tumour. Br J Surg 79:241–244
Japanese Research Society for Gastric Cancer (1981) The general rules for gastric cancer study in surgery and pathology. Jpn J Surg 11:127–139
Yamada S, Okajima K, Isozaki H, Nakata E, Kitade T, Komizo Y (1992) Studies of preoperative imaging diagnosis for the assessment on the lymph node metastasis of gastric cancer (in Japanese with English abstract). Nippon Shokaki Geka Gakkai Zasshi (Jpn J Gastroenterol Surg) 25:1156–1160
Sano T, Okuyama Y, Kobori O, Shimizu T, Morioka Y (1990) Early gastric cancer: Endoscopic diagnosis of depth of invasion. Dig Dis Sci 35:1340–1344
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Sano, T., Kobori, O., Nagawa, H. et al. The macroscopic diagnosis of lymph node metastasis from early gastric cancer. Surg Today 24, 37–39 (1994). https://doi.org/10.1007/BF01676882
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DOI: https://doi.org/10.1007/BF01676882