Surgical experience with 5 n3(+) early gastric carcinoma cases

Abstract

Of 370 patients who underwent a resection for early gastric carcinoma, 317 (85.6%) were N(-), 28 n1(+), 20 n2(+) and five (1.4%) n3 respectively. In this study, n3(+) early gastric cancers were clinicopathologically evaluated and sites of the metastatic nodes were also defined. In addition, a comparative study in DNA ploidy patterns between primary and metastatic node cell was performed according to Hedley's method using a FACS-IV scan of paraffin-embedded tissues. All n3(+) early gastric cancers showed an aneuploidy pattern. R2 or R3 operations are recommended for early gastric carcinomas with aneuploidy pattern and most of the metastatic nodes arise from the identical stem cell line of cancer cells.

Essential pre-treatment imaging examinations in patients with endoscopically-diagnosed early gastric cancer

“…Indication for endoscopic therapies such as EMR and EMCT is determined by tumor histology, depth and size (mucosal cancer less than 2 cm without ulceration). Since it has been reported that lymph node metastasis is extremely rare in such small mucosal cancers [2,5,10-12], clinicians will not entertain the possibility of lymphadenopathy. If the EGC does not meet the above criteria for endoscopic treatment, gastrectomy with D2 lymph node dissection is performed, and indication for modified gastretomy is determined by intraoperative findings [5].…”

“…If the EGC does not meet the above criteria for endoscopic treatment, gastrectomy with D2 lymph node dissection is performed, and indication for modified gastretomy is determined by intraoperative findings [5]. Added to the fact that N3 metastasis of EGC is extremely rare [10-12], detailed preoperative evaluation of lymph nodes is not essential.…”