LYMPH-NODE METASTASIS AND MACROSCOPIC FEATURES IN EARLY GASTRIC-CANCER

The relationship between macroscopic features and the frequency and ex tent of lymph node metastasis was examined retrospectively in 421 pati ents with early gastric cancer. Nodal involvement was evident in 48 pa tients (11.4 %): 7 out of 204 (3.4 %) with mucosal cancer and 41 out o f 217 (19.3 %) with submucosal lesions. The incidence of metastasis to perigastric nodes and extraperigastric nodes was 2.9 % and 0.5 % for mucosal cancer, and 13.8 % and 5.1 % for submucosal cancer, respective ly. There was no metastasis in lesions; less than 1 cm in diameter, bu t the incidence of positive nodes increased with the size of the prima ry lesion. There was a low incidence of lymph node metastasis associat ed with lesions confined to the mucosa and less than 3 cm in size, ele vated types of I and IIa less than 2 cm, and the flat type of IIb, whi le types consisting of a depressed portion such as IIc, III, IIc + III , and IIa + IIc often had not only perigastric but also extraperigastr ic nodal involvement, even when the lesion was small. As early gastric cancer can be cured by surgery, this modality is the treatment of cho ice. Endoscopic therapy in cases with a low involvement of lymph node metastasis can be considered when the patient is in a poor clinical st ate of health.