Current Treatment for Gastric Cancer of the Cardiac Region Takahito Ohta 1 , Masayoshi Mai 1 , Toshihiro Fujimoto 1 , Yutaka Takahashi 1 1Department of Surgery, Cancer Research Institute, Kanazawa University Keyword: 噴門部癌 , 開腹手術 , EMR , 腹腔下手術 pp.1081-1089
Published Date 1997/7/25
DOI https://doi.org/10.11477/mf.1403104972
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 Last two decades, we experienced 55 cases of gastric cancer of the cardiac region. We have studied suitableness of treatment for the gastric cancer of the cardiac region. As a results, incident of nodal involvement was very high in the cases with subserosal invasion. Although the incidence of nodal metastasis of the cases with muscularis propria invasion was not so high, most of the cases with nodal involvement had metastasis to the lymph nodes around the splenic artery. Therefore, the cases with invasion deeper than the muscularis propria should be treated by total gastrectomy combined with pancreatosplenectomy. By the way, resection of the cardiac region should be recommended for the early gastric cancer of the cardiac region, because only one out of eight cases of early cancer had regional lymph node metastasis. Endoscopic mucosal resection (EMR) was an appropriate treatment for the cases without nodal involvement by preoperative assessment. However precise postoperative inspection was important because complete mucosal resection rate was reported to be about 70%. Consequently less invasive laparoscopic surgery may be considered for the cases to which EMR may not be applicable.

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