Problems in the definition and treatment of early gastric cancer

Inoue, Kazuya; Tobe, Takayoshi; Kan, Norimichi; Y, Nio; Sakai, Masahiko; Takeuchi, Eiji; Sugiyama, Tateo

doi:10.1002/bjs.1800780717

Cited by 104 publications

(68 citation statements)

References 13 publications

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“…Many authors have reported that, in some patients, there are N2 lymph node metastases of gastric carcinoma which invade to the submucosal layer [13][14][15][16][17]. Survival rate.…”

Section: Resultsmentioning

confidence: 99%

Effect of fat volume on postoperative complications and survival rate after D2 dissection for gastric cancer

et al. 2000

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“…Many authors have reported that, in some patients, there are N2 lymph node metastases of gastric carcinoma which invade to the submucosal layer [13][14][15][16][17]. Survival rate.…”

Section: Resultsmentioning

confidence: 99%

Effect of fat volume on postoperative complications and survival rate after D2 dissection for gastric cancer

et al. 2000

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“…There are some reports that EGC patients with nodal metastasis have a poorer prognosis than those with cancernegative nodes (Habu et al, 1986;Marczell et al, 1988;Inoue et al, 1991;Lawrence and Shiu, 1991;Santoro et al, 1991;Guadagni et al, 1993;Pinto et al, 1994). This aspect is supported by our findings not only for the LLND group but also for the ELND group.…”

Section: Survivalmentioning

confidence: 99%

“…Some reports indicate that the survival rate differs according to whether the depth of invasion is mucosal or submucosal (Gentsch et al, 1981;Takagi et al, 1987;Craanen et al, 1991;Lawrence and Shiu, 1991;Inoue et al, 1991;Guadagni et al, 1993;Moreaux and Bougaran, 1993). It is well established that, as the depth of gastric carcinoma invasion into the gastric wall increases, the frequency and the degree of nodal metastasis also increases.…”

Section: Survivalmentioning

confidence: 99%

“…It is well established that, as the depth of gastric carcinoma invasion into the gastric wall increases, the frequency and the degree of nodal metastasis also increases. Lymph nodal metastasis is present in 1.8-4.8% of EGC patients with mucosal invasion, but in 16.7-23.8% of those with submucosal invasion (Habu et al, 1986;Korenaga et al, 1986;Ohta et al, 1987;Iriyama et al, 1989;Sowa et al, 1989;Inoue et al, 1991;Moreaux and Bougaran, 1993). Thus, the local invasiveness of EGC may be correlated with the survival rate (Lawrence and Shiu, 1991).…”

Section: Survivalmentioning

confidence: 99%

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Rationale for extensive lymphadenectomy in early gastric carcinoma

Miwa

Miyazaki²,

Sahara³

et al. 1995

Br J Cancer

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Summary The incidence of nodal metastasis in early gastric carcinoma (EGC) is 10-20%. However, the optimal nodal dissection for early gastric carcinoma has not been established. A retrospective study was conducted in 392 consecutive patients who underwent potentially curative distal gastrectomy for EGC between 1962 and 1990. Of these 295 patients treated after September 1972 were prospectively entered into an extensive lymphadenectomy protocol. These patients were compared with 97 patients with simple gastrectomy in respect of the causes of death after surgery and the 10 year disease-specific survival rate. The incidence of nodal metastasis in early gastric carcinoma patients was 13.0%. Operative mortality from extensive lymphadenectomy was almost the same as from simple gastrectomy (2.0% and 2.1% respectively). Extensive al., 1987; Ohta et al., 1987; Marczel et al., 1988;Lehnert et al., 1989;Percivale et al., 1989;Farley et al., 1992;Maehara et al., 1993). Nevertheless, the optimal extent of lymph node dissection for EGC has not been well established. Japanese surgeons normally perform extensive lymphadenectomy for EGC because a certain proportion of these patients have lymph nodal involvement and carcinoma recurrence is not rare. In contrast, most surgeons in Western countries do not use aggressive surgery (Cuschieri, 1986;Heberer et al., 1988;Irvin and Bridger, 1988;Heesakkers et al., 1994), perhaps because of uncertainty regarding improvement in the survival rate and the high operative risk associated with extensive lymph node dissection (Dent et al., 1988;Heberer et al., 1988;Irvin and Bridger, 1988).To evaluate the therapeutic value of extensive lymphadenectomy in EGC, we analysed retrospectively the causes of death after surgery and compared the 10 year disease-specific survival rate in patients who had received extensive lymphadenectomy with patients who had received simple gastric resection. (LLND). ELND was performed beginning in September 1972. The LLND group consisted of 68 patients before September 1972 and 29 patients after. Each surgical procedure is outlined below. The subjects were followed up, and the effect of lymph node dissection on their 10 year disease-specific survival was evaluated. The operative and pathological findings were assessed according to the guidelines of the Japanese Research Society for Gastric Cancer (1981). The median age of the patients at the time of operation was 59 years, with a range of 18-84 years. There were 271 males (69%) and 121 females (31%). SurgeryThe ELND gastrectomy was performed as follows: the entire greater omentum, superior leaf of the mesocolon, pancreatic capsule and lesser omentum were removed en bloc with the cancerous distal portion of the stomach. Each of the supplying gastric arteries was ligated and divided at its origin, and the group 1 lymph nodes (nl), namely those along the lesser and greater curvatures, as well as the supra-and infra-pyloric lymph nodes, were completely dissected. In addition, the group 2 lymph nodes (n2) located at the...

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“…A neoplasia gástrica com profundidade de invasão restrita à camada mucosa, sem componente ulceroso ou cicatricial, demonstra acometimento linfonodal em cerca de 1 a 3% e quando há invasão de camada de submucosa o envolvimento linfodonal é de cerca de 11 a 20% (SUE-LING et al, 1992;YAMAO et al, 1996;KOFUJI et al, 1997;KURIHARA et al, 1998;NAMIENO et al, 1998;NAKAMURA et al, 1999;YASUDA et al, 1999;GOTODA et al, 2000;KUNISAKI et al, 2001;YAMADA et al, 2001). Embora a profundidade da invasão tumoral esteja associada com a sobrevida, análise multivariada demostrou que não é fator prognóstico independente (INOUE et al, 1991). Os achados de êmbolos linfáticos, ulceração e tumor maior que três centímetros se mostraram como fatores independentes para acometimento linfonodal.…”

Section: 013unclassified

Fatores preditivos para recidiva local e para ressecção incompleta de adenocarcinoma gástrico precoce tratado através da exérese endoscópica

Hondo¹

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Problems in the definition and treatment of early gastric cancer

Cited by 104 publications

References 13 publications

Effect of fat volume on postoperative complications and survival rate after D2 dissection for gastric cancer

Effect of fat volume on postoperative complications and survival rate after D2 dissection for gastric cancer

Rationale for extensive lymphadenectomy in early gastric carcinoma

Fatores preditivos para recidiva local e para ressecção incompleta de adenocarcinoma gástrico precoce tratado através da exérese endoscópica

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