Is lymphadenectomy needed for all submucosal gastric cancers?

The European Journal of Surgery = Acta Chirurgica
H YamadaK Sugihara

Abstract

To find out if it is feasible to extend the indication for local resection of submucosal gastric cancer without increasing the risk of lymph node metastases. Retrospective study. University hospital, Japan. 104 patients with gastric cancer confined to the submucosal layer who underwent conventional gastrectomy with lymphadenectomy. The risk of nodal metastases was analysed retrospectively depending on the depth of submucosal invasion, size of the tumour, and other clinicopathological findings. The degree of submucosal invasion, size of the tumour, and incidence of lymph node metastasis. 15/104 patients (14%) had lymph node metastases. No patient in whom submucosal invasion was less than 500 microm or tumour was less than 15 mm in diameter developed lymph node metastases. Fewer patients had lymphatic permeation (37/89) and venous involvement (21/89) in the group without lymph node metastases. These data seem to support the hypothesis that early, minimally invasive, gastric cancer measuring < 15 mm in diameter could be treated by endoscopic mucosal or local resection, and gastrectomy with lymphadenectomy might be unnecessary.

Citations

May 30, 2013·World Journal of Gastroenterology : WJG·Gang RenWen-Hua Li
May 11, 2004·Langenbeck's Archives of Surgery·Norihiro Yuasa, Yuji Nimura
Feb 25, 2014·The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi·Min Woo ChungSung Bum Cho
Apr 30, 2013·The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi·Moon Han ChoiMoon Sung Lee
Oct 24, 2007·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Hiroyuki YamadaKenichi Sugihara
Apr 16, 2005·The Cancer Journal·Koji OtsukaAlan T Lefor
Oct 1, 2008·Gastric Cancer : Official Journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association·Robert Michael Kwee, Thomas Christian Kwee
Oct 19, 2005·Journal of Surgical Oncology·Ryoko SasakiKazuyoshi Saito
Aug 11, 2016·European Journal of Gastroenterology & Hepatology·Se Hoon SohnTae Nyeun Kim
Nov 10, 2004·World Journal of Gastroenterology : WJG·Do-Joong ParkKuk-Jin Choe

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