GastroenterologiaJaponica Vol. 10, No. 1. --1975--
--Original Article--
SURGICAL CONSIDERATIONS OF EARLY GASTRIC CANCER T a d a o K A B A K I N O , M.D., Hiroshi NEI, M.D., Takaaki ABE, M.D., and Junichi W A K I S A K A , M.D.
1st Department of Surgery, Kurume University School of Medicine Takeshi E M U R A , M.D., Masatake Y A S U M O T O , M.D., Ikuzo A M A N O , M.D. and Nobuhiko OKABE, M.D.
2nd Department of Medicine, Kurume University School of Medicine Summary Metastasis to lymph nodes was seen more higher rate in plotruding lesion, especially in Type IIa and IIa + IIc than in concaving lesion. In view of the metastasis to the secondary regional lymph nodes or the third regional lymph nodes, care should be taken in the eradication of lymph node in early gastric cancer of Type IIc. Five-year survival rate was 88.9% of the resected cases of early gastric cancer.
Key Words: early gastric cancer,protruding lesion, concaving lesion Introduction
Materials and Methods
Since 1963, the diagnosis of early gastric cancer has become easier due to the development of double contrast radiography and endoscopy. Consequently, findings in early gastric cancer among totally resected gastric cancer are increasing. There are several types of early gastric cancer, of which cancer localized in the mucosal layer of the stomach was described
Total or partial gastrectomy was performed in 161 cases of early gastric cancer from J a n u a r y 1963 to December 1973 at our surgical clinic. Location of tumor and regional metastasis to lymph nodes are referred to the general rules for the gastric cancer by Japanese Society for gastric cancer 6). T h e 161 cases of early gastric cancer are classified according to the classification of the Japanese Society of Endoscopy, as follows: 65 cases of T y p e IIc, 30 cases of T y p e I I c I I I , 16 cases of T y p e I and 15 cases of T y p e IIa. Cases mainly with T y p e I I c account for 65.2%, and cases with predominant T y p e I I I account for only 6.8%. Protruding lesion was found in 27.9% and concaving lesion in 72.1% with higher incidence of concaving lesion ( T a b l e 1).
as Carcinoma in situ by Mallory l), Oberfl~chlicher Schleimhautkrebs by Konjetzny 2), Superficial carcinoma by Ewing 3), Superficial spreading carcinoma by chenkrebs by R6ssle 5).
Stout 4), Oberfla-
The Committee of the Japanese Society of Endoscopy defined early gastric cancer as a case confined to the mucosal or submucosal layer of the stomach, regardless of the presence of metastasis to lymph nodes.
2
T. K A B A K I N O E T AL.
Table I.
Radiological endoscopic classification
Incidence of the early gastric cancer
Number of cases
u r e d 18 • 1 6 c m , T y p e I I a + while the smallest was T y p e l i b
16 1 1
9.9 0.6
IIa IIa + IIc IIa + I I b IIa + I + IIb
15 7 2 1
9.3 4.3 1.2 0.6
2
1.2
IIc IIc + IIa IIc + III
65 10 30
40.4 6.2 12.4
65.2
III I I I + IIa III + IIc
4 2 5
2.5 1.2 3.1
6.8
IIb
Total
11.2
Size (cm)
--Original Article--
SURGICAL CONSIDERATIONS OF EARLY GASTRIC CANCER T a d a o K A B A K I N O , M.D., Hiroshi NEI, M.D., Takaaki ABE, M.D., and Junichi W A K I S A K A , M.D.
1st Department of Surgery, Kurume University School of Medicine Takeshi E M U R A , M.D., Masatake Y A S U M O T O , M.D., Ikuzo A M A N O , M.D. and Nobuhiko OKABE, M.D.
2nd Department of Medicine, Kurume University School of Medicine Summary Metastasis to lymph nodes was seen more higher rate in plotruding lesion, especially in Type IIa and IIa + IIc than in concaving lesion. In view of the metastasis to the secondary regional lymph nodes or the third regional lymph nodes, care should be taken in the eradication of lymph node in early gastric cancer of Type IIc. Five-year survival rate was 88.9% of the resected cases of early gastric cancer.
Key Words: early gastric cancer,protruding lesion, concaving lesion Introduction
Materials and Methods
Since 1963, the diagnosis of early gastric cancer has become easier due to the development of double contrast radiography and endoscopy. Consequently, findings in early gastric cancer among totally resected gastric cancer are increasing. There are several types of early gastric cancer, of which cancer localized in the mucosal layer of the stomach was described
Total or partial gastrectomy was performed in 161 cases of early gastric cancer from J a n u a r y 1963 to December 1973 at our surgical clinic. Location of tumor and regional metastasis to lymph nodes are referred to the general rules for the gastric cancer by Japanese Society for gastric cancer 6). T h e 161 cases of early gastric cancer are classified according to the classification of the Japanese Society of Endoscopy, as follows: 65 cases of T y p e IIc, 30 cases of T y p e I I c I I I , 16 cases of T y p e I and 15 cases of T y p e IIa. Cases mainly with T y p e I I c account for 65.2%, and cases with predominant T y p e I I I account for only 6.8%. Protruding lesion was found in 27.9% and concaving lesion in 72.1% with higher incidence of concaving lesion ( T a b l e 1).
as Carcinoma in situ by Mallory l), Oberfl~chlicher Schleimhautkrebs by Konjetzny 2), Superficial carcinoma by Ewing 3), Superficial spreading carcinoma by chenkrebs by R6ssle 5).
Stout 4), Oberfla-
The Committee of the Japanese Society of Endoscopy defined early gastric cancer as a case confined to the mucosal or submucosal layer of the stomach, regardless of the presence of metastasis to lymph nodes.
2
T. K A B A K I N O E T AL.
Table I.
Radiological endoscopic classification
Incidence of the early gastric cancer
Number of cases
u r e d 18 • 1 6 c m , T y p e I I a + while the smallest was T y p e l i b
16 1 1
9.9 0.6
IIa IIa + IIc IIa + I I b IIa + I + IIb
15 7 2 1
9.3 4.3 1.2 0.6
2
1.2
IIc IIc + IIa IIc + III
65 10 30
40.4 6.2 12.4
65.2
III I I I + IIa III + IIc
4 2 5
2.5 1.2 3.1
6.8
IIb
Total
11.2
Size (cm)
