Lymph node metastasis in early gastric cancer

From 1969 through 1984, 304 case of early gastric cancer (EGC) were resected. Nodal status was studied in 272 cases in which lymph node dissection was performed. The lymph nodes were negative for metastasis in 90% of the cases. In 7%, metastasis was noted in the Group 1 lymph nodes alone and in 3%, as far as the Group 2 nodes. But in no case were the Group 3 involved. The 10-year survival rate was poorer in patients with positive nodes than in those with negative nodes (52.8% vs. 94.1%). Cancer recurred more often in patients who had no lymph node dissection than in those with node dissection (9.4% vs. 1.5%). Lymph node metastasis was more frequent in the following EGC types: macroscopically combined type, over 5 cm, and with submucosal invasion. Dissection as far as the Group 2 nodes should be routinely performed even in EGC, especially in cases with the above-mentioned characteristics.