[Studies on the surgical therapy of early gastric cancers]

Surgical treatment were performed for 1190 patients with early gastric cancer at the Center for Adult Diseases, Osaka, during these 20 years. We studied on the following three clinical problems in surgical therapies for early gastric cancer; appropriate margin to resect the stomach, lymph node dissection and adjuvant chemotherapy. It is important to resect the stomach to allow an enough surgical margin, because of multiple foci and ill-defined lesion. During surgical operation special attention should be paid to multiple foci or unexpected extension of the lesion. As to lymph node dissection, N1 and N2 lymph nodes have to be removed but in elevated type lesions invading within mucosal layer, the dissection of N1 only can be permitted. Early gastric cancer patients with lymph nodes metastases had less favorable survival after surgical operation, indicating the necessity of adjuvant chemotherapy.