CARCINOMATOUS INFILTRATION INTO THE SUBMUCOSA AS A PREDICTOR OF LYMPH-NODE INVOLVEMENT IN EARLY GASTRIC-CANCER

The clinicopathologic features of 114 patients with resectable early g astric cancer (EGC) invading the submucosa were examined retrospective ly with respect to lymph node involvement and the possibility of perfo rming a minimally invasive operation. Patients were divided into node- positive (n = 25) and node-negative (n = 81) groups. Among several pat hologic factors, the diameter of the tumor and lymphatic involvement w ere significantly correlated with nodal involvement. Within the submuc osal layer the depth of invasion and the horizontal cancerous expansio n also correlated with lymph node disease (p < 0.05). The size of the tumor did not correlate with the length of submucosal infiltration (r = 0.12, p = 0.1). Patients with both slight invasion into the submucos a and less than 5 mm of horizontal expansion were often negative for l ymph node involvement and thus may benefit from local surgery as an al ternative to gastrectomy.