CLINICAL STUDY OF THE APPROPRIATE DEGREE OF LYMPH NODE DISSECTION FOR EARLY GASTRIC CANCER

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  • 早期胃癌の適正なリンパ節郭清範囲の検討
  • とくにpm癌との比較において
  • PARTICULARLY IN COMPARISON WIHH pm VARCINOMA OF THE STOMACH

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In order to determine a rational approach to surgery for early gastric cancer, i.e., the appropriate extent of lymph node dissection,274 cases of early gastric cancer (dissection of R2 or over) resected at the Department of Surgery, Osaka Medical College between August 1978 and December 1986 were ocmpared with 82 cases of pm carcinoma at a similar stage. The lymph node metastasis rate was 4.9% in m carcinoma,7.9% in sm-1 carcinoma,22.4% in sm-2 carcinoma, and 45.1% in pm carcinoma. In early gastric carcinoma, metastases were not observed in the C-region, but in poorly differentiated carcinoma in the A-region, a high rate of lymph node metastasis (19.4%)was noted. Among cases of sm-2 carcinoma, the U1 (+) group, growth pattern H type, and infiltrative pattern microalveolar type had high rates of lymph node metastasis, as high as those of pm carcinoma. Considering these results for early gastric cancer, R2 or selective R3 lymph node dissection is believed necessary. It is also felt that a less radical approach may be applied to early gastric cancer in the C-region less than 1 cm in length.

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