INDICATION OF REDUCED RADICAL GASTRECTOMY FOR EARLY GASTRIC CANCER IN TERMS OF HISTOLOGIC LYMPH NODE METASTASIS

In this study, reduced radical gastrectomy (RRG) is defined as gastrectomy with less than group 1 lymph node dissection for early gastric cancer without lymph node metastasis to preserve a remnant stomach volume as great as possible, and 229 cases of early gastric cancer were clinicopathologically analyzed. These cases underwent standard gastrectomy, i.e., gastrectomy with group 2 and/or group 3 lymph node dissection. Under such criteria, the incidence of lymph node metastasis was 0% in mucosal cancer and submucosal cancer less than 2.0cm in diameter located in the lower portion (A). Such patients may be possible candidates for RRG. RRG should not be indicated for early gastric cancers arising in the M region, because a possibility of histologic positive lymph node metastasis could not be denied. Further studies would be demanded for the indication to those in C region. The clinical outcomes of 35 patients with early gastric cancer who underwent gastrectomy with less than group 1 lymph node dissection or endoscopic mucosal resection (EMR) were examined. There were no recurrent in 13 patients who were retrospectively thought to be candidates for RRG, but there were 3 recurrent patients among 16 who were thought not to require RRG. The indications for EMR should be evaluated more carefully.