Is extensive lymphadenectomy necessary for surgical treatment of intramucosal carcinoma of the stomach?
K. Iriyama, T. Asakawa, H. Koike, H. Nishiwaki and H. Suzuki
Second Department of Surgery, Mie University School of Medicine, Tsu, Japan.
This study was undertaken to elucidate those histological and gross
features associated with gastric carcinoma that can be adequately treated
by gastrectomy with less aggressive lymphadenectomy. The frequency of
metastasis to the lymph nodes was analyzed in 514 cases of resected,
solitary, gastric carcinomas. The frequency of metastasis to the lymph
nodes increased in proportion to the increase in the extent of penetration
by the cancer into the gastric wall. Lymph nodes were not involved in cases
of intramucosal carcinoma of the intestinal type, by Lauren's histological
classification. By contrast, metastasis to the lymph nodes was observed in
cases of intramucosal carcinoma of the diffuse type, by Lauren's
classification. We conclude that extensive lymphadenectomy is not mandatory
for patients with intramucosal carcinoma of the stomach of the protruded
type, since the lymph nodes do not become involved in this type of gastric
carcinoma.