Rational lymphadenectomy for early gastric cancer with submucosal invasion: A clinicopathological study

Takeshita, Kimiya; Saeki, Ichiro; Tani, Masao; Honda, Tooru; Saito, Naoya; Endo, Mitsuo

doi:10.1007/s005950050188

Cited by 16 publications

(8 citation statements)

References 10 publications

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“…The increase in node involvement with tumor size (irrespective of histology and cancer depth), ascertained in the present study, is consistent with the findings of previous reports [2,5,[11][12][13][14][15][16][17][18][19][32][33][34][35][36][37][38][39][40]42]. Endoscopic mucosal resection is clearly indicated for differentiated m-cancers less than 1 cm in diameter, given the absence of nodal involvement in these tumors.…”

Section: Discussionsupporting

confidence: 92%

“…However, these earlier reports were, with one exception [31], based on the outcomes of fewer than 1500 subjects (80-1475 cases) [32][33][34][35][36][37][38][39][40][41][42]. Furthermore, there have been no studies on the relationship between preoperative determination of depth of invasion and lymph node metastasis.…”

Section: Discussionmentioning

confidence: 99%

“…The reported frequency of lymph node metastasis in EGC varies from 5.7% to 29% [31][32][33][34][35][36][37][38]. Most studies have reported that the presence of lymph node metastasis decreases the survival rate of EGC patients .…”

Section: Introductionmentioning

confidence: 99%

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Lymph node metastasis and preoperative diagnosis of depth of invasion in early gastric cancer

et al. 2001

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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Lymph node metastasis and preoperative diagnosis of depth of invasion in early gastric cancer

et al. 2001

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“…This finding may be helpful in predicting lymph node metastases preoperatively. Since the preoperative diagnosis of early gastric cancer with lymph node involvement is sometimes difficult [24, 25], immunostaining can be performed on gastric biopsy specimens to evaluate the biological behavior of the tumor and to predict the possibility of lymph node metastases. Treatment according to this judgment may even be reasonable and effective.…”

Section: Discussionmentioning

confidence: 99%

Cooccurrence of Reduced Expression of α-Catenin and Overexpression of p53 Is a Predictor of Lymph Node Metastasis in Early Gastric Cancer

Che

Hokita²,

Natsugoe³

et al. 1999

Oncology

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Background and Objectives: Even though the pathological background contributes to lymph node metastasis, the biological characteristics of tumors have also gained wide attention. In this study, the expression of the cadherin-catenin complex and p53 was studied in early gastric cancer. Their correlation with lymph node metastasis and the predictability of lymph node metastases, by combining these factors, were also discussed. Methods: One hundred and one specimens obtained from surgery were studied by immunohistochemistry using monoclonal anti-E-cadherin, anti-α-catenin and anti-p53 antibodies. Results: Expression of E-cadherin and α-catenin was reduced in 50.5 and 64.4%, respectively. p53 protein staining was positive in 29.7%. There was a significant correlation between E-cadherin and α-catenin expression, but no correlation was found between p53 expression and E-cadherin or α-catenin expression. A reduction in α-catenin expression and p53 overexpression correlated to lymph node metastases, respectively. Multivariate analysis showed that cooccurrence of reduced expression of α-catenin and overexpression of p53 was an independent factor indicating lymph node metastases. Conclusion: A study of both α-catenin and p53 expression may be helpful to predict lymph node metastases in early gastric cancer.

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“…Many authors have clarified clinicopathologic characteristics of node-negative EGC and advocated the indications of local resection or EMR [8, 23, 26, 27, 28, 29, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63](table 1). Although the earlier indication for EMR included only mucosal cancer measuring <1 cm without ulcer or scar [53, 54], the recent indication extended to the tumors confined to the mucosa …”

Section: Endoscopic Treatmentmentioning

confidence: 99%

Modern Treatment of Early Gastric Cancer: Review of the Japanese Experience

Adachi

Shiraishi²,

Kitano³

2002

Dig Surg

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Background: Recently, detections of early gastric cancer (EGC) have been increasing, and the treatment strategies for gastric cancer have been changing. To demonstrate recent clinical experience of EGC in Japan and to assess modern strategies for the treatment of EGC, we investigated the English-language literature of the past 10 years through computer searches. Methods: This article intends to provide gastric surgeons with recent Japanese experience of the treatment for EGC. In a search for modern treatments of EGC, we selected 100 papers published in well-known medical journals, and focused on the following items of EGC: (1) prognostic factors, (2) endoscopic treatment, (3) surgical procedures, and (4) Japanese guidelines. Results: The most important factor influencing the survival of patients with EGC is the status of lymph node metastasis. The incidence of lymph node metastasis is 1–3% for mucosal cancers and 11–20% for submucosal cancers. Endoscopic mucosal resection (EMR) is a technique for the treatment of EGC, and the recent indication includes the tumors confined to the mucosa up to 3 cm in size or those invading the superficial submucosa. Surgical procedures include conventional Billroth I gastrectomy, limited resections, and laparoscopic surgery. Laparoscopic wedge resection using the lesion-lifting method and laparoscopy-assisted distal gastrectomy provide less pain, faster recovery and shorter hospital stay. Guidelines for the treatment of gastric cancer proposed by the Japanese Gastric Cancer Association show that patients with mucosal cancer can be managed by EMR or distal gastrectomy, whereas patients with submucosal cancer are candidates for distal gastrectomy with lymph node dissection. Conclusion: Although the prognosis of patients with EGC depends on the presence or absence of lymph node metastasis, most are successfully treated by modern endoscopic or surgical techniques. Laparoscopic surgery and limited resections will contribute to the better quality of life of patients with EGC.

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Rational lymphadenectomy for early gastric cancer with submucosal invasion: A clinicopathological study

Cited by 16 publications

References 10 publications

Lymph node metastasis and preoperative diagnosis of depth of invasion in early gastric cancer

Lymph node metastasis and preoperative diagnosis of depth of invasion in early gastric cancer

Cooccurrence of Reduced Expression of α-Catenin and Overexpression of p53 Is a Predictor of Lymph Node Metastasis in Early Gastric Cancer

Modern Treatment of Early Gastric Cancer: Review of the Japanese Experience

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