Possibility of Reduction in Lymph Node Dissection in Gastric Submucosal Cancer: In View of Prediction of Lymph Node Metastasis by Logistic Regression Analysis, and Indication for Laparoscopic Resection Yoshiaki Kajiyama 1 , Masahiko Tsurumaru 1 , Harushi Udagawa 1 , Hiroshi Akiyama 1 1Department of Surgery, Toranomon Hospital Keyword: sm癌深達度細分類 , リンパ節転移 , 多変量解析 , ロジスティック回帰分析 , 腹腔鏡下手術 pp.63-69
Published Date 1997/1/25
DOI https://doi.org/10.11477/mf.1403104954
  • Abstract
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 Since 1996, laparoscopic resection has been approved in Japan as a method for curative treatment of gastric mucosal cancer, but it is still controversial whether laparoscopic resection without lymph node dissection or with limited lymph node dissection is indicated for gastric submucosal cancer, because the frequency of lymph node metastasis in submucosal cancer is nearly 20%. The objective of this study was to establish the indication for laparoscopic resection of submucosal carcinoma from the standpoint of lymph node metastasis using logistic regression analysis and to assess the classification of submucosal cancer into sm1 ~ sm3. The covariants which could predict lymph node metastasis were lymph vessel invasion, size of tumor, presence of ulceration and venous invasion. When we could not determine precisely the presence of vessel invasion prior to resection, classification of submucosal cancer into sm1 ~ sm3 became important. From our study laparoscopic resection with limited lymph node dissection (D1) is indicated for well differentiated sm1 cancer. However, we cannot diagnose precisely the degree of submucosal invasion or vessel invasion prior to resection, and we think it is dangerous to resect laparoscopically gastric cancer that has been diagnosed with submucosal invasion prior to surgery.

Copyright © 1997, Igaku-Shoin Ltd. All rights reserved.


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