RADICAL LYMPHADENECTOMY IN THE MANAGEMENT OF EARLY GASTRIC-CANCER

Lymph node metastasis in patients with early gastric cancer was evalua ted prospectively to determine whether radical (D-2) lymphadenectomy i s appropriate in such cases. Twenty-eight (18 per cent) of 156 patient s having surgery for gastric cancer had early disease. Lymph node meta stasis was found in 12 of the 28 patients. Metastasis was more likely in submucosal than mucosal early gastric cancer (nine of 14 versus thr ee of 14; P=0.024, Fisher's exact test). In two of three patients with metastasis at the N-2 level, the N-1 nodes were entirely clear. This study shows a higher incidence of lymph node metastasis than has been reported previously in both the UK and Japan. The high incidence of ly mph node metastasis in early gastric cancer supports the continuing us e of radical lymphadenectomy in patients who are fit for such major.