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Updated: Jun 16, 2026
Intraoperative Gastroscopy for Tumor Localization in Laparoscopic Surgery for Gastric Adenocarcinoma
Published on: August 9, 2016
[Clinical study of lymph node dissection for early gastric cancer]
Xiang Hu1, Liang Cao, Da-yu Tian
1Department of General Surgery, First Affiliated Hospital of Dalian Medical University, Dalian 116011, China.
Objective:
To explore the pattern of lymph node metastasis and to determine a rational approach of surgery for early gastric cancer (EGC).
Methods:
Between January 1994 and January 2008, 165 patients with EGC were given D2 or over dissection. Clinicopathologic data of this group was analyzed retrospectively.
Results:
The lymph node metastasis rate was 3.8% in mucosa carcinoma (m-carcinoma), and was limited in first-tier; it was 25.7% in submucosa carcinoma (sm-carcinoma) and metastasized to second-tier and third-tier. Lymph node metastasis rate of EGC in u-region was low and was only limited in first-tier. But, in L-region, second- and third-tier lymph node metastasis was found in 5.2% and 0.9% of the patients, respectively. Second-tier lymph node metastasis was found in No. 7, 8, 9 and third-tier in No. 12, 14V, 16. The tumor size and lymph node metastasis was related closely, the lymph node metastasis only involved first-tier in m-carcinoma with a diameter < 5 cm, but the second-tier was involved in all sm-carcinoma. Significant difference was found in survival depending on the grade of tumor invasion: the cumulative 5-year survival rate was 97.3% in the m-carcinoma and was 87.6% in the sm-carcinoma (P = 0.019). There was no significant difference in survival between the extents in lymph node dissection (D2 93.8%, D3 91.7%) (P = 0.677).
Conclusions:
D2 and D2+ lymph node dissection is necessary for sm-early gastric cancer. A less radical approach could be applied to m-early gastric cancer in the u-region with a diameter < 2 cm.
