J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 3094KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 81(8): 724-730, 1980

Original article

A LONG-TERM POSTOPERATIVE RESULTS OF EARLY GASTRIC CANCER
－PROGNOSTIC ANALYSIS ON EXTENT OF DISSECTION－

*) Department of Surgery, Tokyo Medical and Dental University, School of Medicine
**) Department of Pathology, Tokyo Medical and Dental University, School of Medicine

Kimiya Takeshita*), Hiroshi Habu*), Kanji Yaegashi*), Renzo Hirayama*), Tadahiko Miyanaga*), Kazuo Hoshi*), Matsutoshi Menjo*), Nozomu Aoki**)

Since lymphnode metastasis is not a rare occurrence even in early gastric cancer, it is generally advised that similar extent of lymphnode dissection should be done as in advanced cancer. This study was undertaken to determine whether extent of lymphnode dissection will influence a longterm survival rate. Two-hundred and twenty-two cases of resected early gastric cancer during last 18 years were divided into 3 groups according to extent of lymphnode dissection: R0 (simplegastrectomy) 26 cases, R1 (R0 + omentectomy) 81, R2 (R1 + lymphadenectomyalong all branches of celiac artery) 115.
The results is as follows:
1) Cumulative 10-year survival rate (mean±S.E.M.) was 100% in R0, 93.4±3.6% in R1 and 98.6±1.4% in R2 with no statistical significance.
2) Cumulative 10-year survival rate was 97% in mucosal cancer and 96% in submucosal cancer.
3) No significant difference in 10-year survival between positive lymphnode metastasis group (87%) and negative group (97%).
4) Significantly less 10-year survival rate (95%) in well differentiated adenocarcinoma (papillary and tubular) than other histological types (100%).
5) Only 3 patients died from recurrence. Primary carcinoma in those 3 patients were protruded and well differentiated adenocarcinoma with extensive vascular permeation. Cause of death was hepatic metastasis in all.
Conclusions:
1) As for depth of invasion and incidence of lymphnode metastasis, R0, R1, and R2 were comparable with no statistic difference.
2) Since the extent of lymphnode dissection did not provide significant prognostic influence to 10-year survival rate in early gastric cancer, less extent dissection such as R0 or R1 might be warranted in poor-risk or elderly patients.
3) Protruded, well differentiated adenocarcinoma with vascular permeation was considered much risky type of gastric cancer from aspect of recurrence.

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