[Surgical treatment of early gastric carcinoma]

From January 1965 until December 1982, early gastric carcinoma cases comprised 765 of 2,235 curative resections and 17 of 620 noncurative resections, for a total of 782 cases. The rate of lymph node metastasis for mucosal carcinoma was 1.2%, and that for submucosal carcinoma was 18.2%. Gastrectomy with removal of the second-group lymph node proved adequate for submucosal carcinoma. The five-year survival rates for mucosal carcinoma and for submucosal carcinoma were 94.9% and 93.6% respectively. The rate of recurrence of mucosal carcinoma was 0.6%, against 2.5% for submucosal carcinoma. Adjuvant chemotherapy is necessary to obtain improved surgical results for submucosal carcinoma. Important factors affecting the recurrence of submucosal carcinoma are lymph node metastasis, macroscopic findings and histological findings. Ten out of 17 cases of noncurative resection had cancer cells at the resection margin, caused by inadequate resection.