Gastric Carcinoma Confined to the Muscularis Propria: How Can We Detect, Evaluate, and Cure Intermediate-Stage Carcinoma of the Stomach?

Nakamura, Kenjiro; Kamei, Takafumi; Ohtomo, Naoki; Kinukawa, Naoko; Tanaka, Masao
August 1999
American Journal of Gastroenterology;Aug1999, Vol. 94 Issue 8, p2251
Academic Journal
OBJECTIVE: The most important surgical strategy for advanced gastric cancer is its detection at the curative stage. The aim of this study was to characterize the curable intermediate stage gastric carcinomas. METHODS: Of 1120 consecutive patients who underwent gastric resection for primary gastric cancer from 1979 through 1996, 94 patients were histologically diagnosed as having cancer confined to the muscularis propria (mp cancer), analyzed clinicopathologically, and compared with patients with early and serosal cancers. RESULTS: The operative incidence of mp cancer was around 8% among cases of gastrectomy, and the ratio of mp cancer to advanced cancer began to increase in 1991. Mp cancer was at a statistically intermediate stage, between early and serosal cancers in terms of symptoms, surgical curability (96%), size and histology of the tumor, and the rate of lymph node metastasis (46%). Preoperative assessments of tumor depth were unclear using radiology and endoscopy; however, 35% of 31 cases studied were diagnosed precisely by endoscopic ultrasonography (EUS). Accuracy of lymph node metastasis diagnosis was the same (65%) by preoperative EUS and by surgeon: however, sensitivity of the surgeon's assessment was higher (69% vs 38%) and specificity of EUS was higher (83% vs 39%). The 5-yr survival rate was 85%, which was significantly better than that of serosal cancer and similar to that of early cancer. Patient outcome was not affected by lymph node metastasis or macroscopic type of tumor. CONCLUSIONS: Mp cancer should be considered an inter-mediate- stage cancer. Surgery with level 2 lymph node dissection should provide a cure rate similar to that for early cancer.


Related Articles

  • Skip lymph node metastasis in gastric cancer: is it skipping or skipped? Choi, Yoon; An, Ji; Guner, Ali; Kang, Dae; Cho, In; Kwon, In; Shin, Hyun; Hyung, Woo; Noh, Sung // Gastric Cancer;Jan2016, Vol. 19 Issue 1, p206 

    Background: Skip metastasis is the presence of a metastatic lymph node (LN) in an extraperigastric (EP) area without perigastric (PG) involvement. The mechanism and prognosis of skip metastasis are still unknown. The purpose of this study was to scrutinize the clinical significance of skip...

  • Lymph Node Metastasis, a Unique Independent Prognostic Factor in Early Gastric Cancer. Zhao, Bai-Wei; Chen, Yong-Ming; Jiang, Shan-Shan; chen, Yin-Bo; Zhou, Zhi-Wei; Li, Yuan-Fang // PLoS ONE;7/8/2015, Vol. 10 Issue 7, p1 

    Background: Lymph node metastasis (LNM) has been shown to be related to the prognosis of early gastric cancer (EGC). The choice of optimal treatment depends on an accurate pre-operative assessment of LNM status in EGC patients. However, in China, where EGC cases account for only a small part of...

  • Prognostic Factors on Overall Survival in Lymph Node Negative Gastric Cancer Patients Who Underwent Curative Resection. Ji Yun Jeong; Min Gyu Kim; Tae Kyung Ha; Sung Joon Kwon // Journal of Gastric Cancer;Dec2012, Vol. 12 Issue 4, p210 

    Purpose: To assess independent prognostic factors for lymph node-negative metastatic gastric cancer patients following curative resection is valuable for more effective follow-up strategies. Materials and Methods: Among 1,874 gastric cancer patients who received curative resection, 967 patients...

  • Survival of patients treated by an autonomic nerve-preserving gastrectomy for early gastric cancer. SASADA, SHINSUKE; NINOMIYA, MOTOKI; NISHIZAKI, MASAHIKO; HARANO, MASAO; OJIMA, YASUTOMO; MATSUKAWA, HIROYOSHI; SHIOZAKI, SHIGEHIRO; OHNO, SATOSHI; TAKAKURA, NORIHISA // Surgery Today;May2010, Vol. 40 Issue 5, p444 

    Autonomic nerve preservation in a gastrectomy for gastric cancer improves the postoperative quality of life. We retrospectively examined the survival of patients treated by an autonomic nerve-preserving gastrectomy in comparison to the survival of the patients treated by a conventional...

  • The risk factors for lymph node metastasis in early gastric cancer patients who underwent endoscopic resection: is the minimal lymph node dissection applicable? Son, Sang; Park, Ji; Ryu, Keun; Eom, Bang; Yoon, Hong; Cho, Soo; Lee, Jong; Kim, Chan; Lee, Jun; Kook, Myeong-Cherl; Choi, Il; Kim, Young-Woo // Surgical Endoscopy;Sep2013, Vol. 27 Issue 9, p3247 

    Purpose: The purpose of this study was to identify risk factors associated with lymph node (LN) metastasis in early gastric cancer patients who underwent endoscopic resection (ER) and to evaluate the feasibility of minimal LN dissection in these patients. Methods: From January 2001 to March...

  • Subtotal gastrectomy as treatment for distal multifocal early gastric cancer. Morgagni, Paolo; Marfisi, Caterina; Gardini, Andrea; Marrelli, Daniele; Saragoni, Luca; Roviello, Franco; Vittimberga, Giovanni; Garcea, Domenico; Italian Research Group for Gastric Cancer // Journal of Gastrointestinal Surgery;Dec2009, Vol. 13 Issue 12, p2239 

    Introduction: Multifocal early gastric cancer (MEGC) is frequently observed and represents a serious risk when minimally invasive treatments are performed.Patients and Methods: We present the experience of two Italian centers situated in a relatively high incidence area...

  • Billroth II rezeksiyonlu hastalarda gastrik stump kanseri. HASDEMİR, Ahmet Oğuz; BÜYÜKAŞIK, Oktay; KAHRAMANSOY, Nurettin; YILMAZ, Erdal; ÇÖL, Cavit // Turkish Journal of Oncology / Türk Onkoloji Dergisi;Jun2011, Vol. 26 Issue 2, p61 

    OBJECTIVES The patients who had Billroth II gastric resections according to clinicopathological features of gastric stump cancer (GSC) were evaluated. METHODS Seven cases of GSC treated between 1995 and 2005 years were reviewed retrospectively. RESULTS In the study, there were 6 men and 1 woman...

  • Survival and surgical outcomes of cardiac cancer of the remnant stomach in comparison with primary cardiac cancer. Yi Wang; Chang-Ming Huang; Jia-Bin Wang; Chao-Hui Zheng; Ping Li; Jian-Wei Xie; Jian-Xian Lin; Jun Lu // World Journal of Surgical Oncology;2014, Vol. 12 Issue 1, p1 

    Background Although cardiac cancer of the remnant stomach and primary cardiac cancer both occur in the same position, their clinical characteristics and outcomes have not been compared previously. The objective of this study was designed to evaluate the prognosis of cardiac cancer of the remnant...


    Background: Lymph node ratio and lymph node status are the most important prognostic factors in the patients with gastric carcinoma, and the depth of wall invasion, and the prognostic significance of the histological type is unclear. The extent of stomach resection in gastric cancer depends on...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics