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Lymph node metastases in gastric cancer invading the submucosal layer
A Tsuchiya1, Y Kikuchi, Y Ando
1Department of Surgery II, Fukushima Medical College, Japan.
Summary
For early gastric cancer invading submucosa, lymph node metastasis increases with invasion depth. Gastrectomy with R2 lymphadenectomy is suitable when preoperative invasion depth is uncertain.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Pathology
Background:
- Early gastric cancer (EGC) invading submucosa presents a risk of lymph node metastasis.
- Accurate preoperative assessment of invasion depth can be challenging.
Purpose of the Study:
- To determine the incidence of lymph node metastasis in EGC invading submucosa.
- To correlate lymph node metastasis with clinicopathological variables.
- To evaluate the appropriateness of gastrectomy with R2 lymphadenectomy for EGC.
Main Methods:
- Retrospective analysis of 80 patients with EGC invading submucosa.
- All patients underwent curative gastric resection with R2 lymphadenectomy.
- Histological examination for lymph node metastasis and correlation with clinicopathological factors.
Main Results:
- Lymph node metastasis was detected in 15 out of 80 patients (18.75%).
- Nodal involvement significantly increased with greater depth of submucosal invasion.
- No correlation was found between lymph node metastasis and histological differentiation.
- No patient died of gastric cancer during the follow-up period.
Conclusions:
- Gastrectomy with R2 lymphadenectomy is an effective surgical approach for EGC invading submucosa, especially when preoperative diagnosis is uncertain.
- The depth of invasion is a critical factor predicting lymph node metastasis in EGC.