[Clinicopathological features and surgical treatment of early gastric cancer]

We analyzed retrospectively the clinicopathological data obtained from 126 patients with early gastric cancer (EGC) to elucidate the relationship between pathological patterns and lymphatic metastasis and the criteria of selecting appropriate surgery. Lymph node metastasis was 3.1% (2/65) in mucosal and 16.4% (10/61) in submucosal tumors respectively (P < 0.05). 26 patients with tumors smaller than 10 mm had no lymphatic metastasis, and 100 patients with tumors larger than 10mm in size had 8% (8/100) n1 positive, 4% (4/100) n2 positive and 7% (7/100) lymphatic duct invasion (P < 0.05). The 5-year survival rate in patients with lymphatic metastasis (79%, 15/19) was significantly lower than that in patients without lymphatic metastasis (97.2%, 104/107) (P < 0.01). It seemed that the most important prognostic factor is whether the presence of lymphatic metastasis or not. Lymphadenectomy is expected to improve the survival rate in EGC. D2 procedure is generally recommended as a standard operation for EGC, especially for the submucosal or larger lesion. Anyhow, D1 operation is sufficient for mucosal or smaller cancer, and D3 is suitable only for EGC patients with multifoci, superficially spreading type and group 3 lymph node metastasis.