Surgical Treatment of Early Gastric Cancers Kunio Takagi 1 1Hayashi Surgical Hospital Keyword: 早期胃癌 , 内視鏡的切除 , 局所切除 , 組織学的深達度 pp.115-126
Published Date 1993/2/26
DOI https://doi.org/10.11477/mf.1403106093
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 The choice of treatment of early gastri ccancer, depending on the size and the depth invasion of tumor, has changed recently. Endoscopic resection (ER) has been applied to type Ⅱa and Ⅱc early gastric cancers whose lesions are 1 cm or less in size. The indication for limited surgery for early gastric cancer includes tumors resectable by ER. Type Ⅱa and Ⅱc early gastric cancers over 2 cm or more in size are out of indicatio for ER. However, we first perform ER for diagnosis of depth invasion, then patients undergo local gastric resection. Based on our study, we propose the choice of treatment as follows: 1) ER is indicated for Ⅱa (differentiated adenocarcinoma) less than 2 cm in size and Ⅱc (differentiated and poorly differentiated adenocarcinoma) less than 1cm in size. 2) Local resection is recommended for lesions 2 to 3 cm in size with mucosal or minimal submucosal invasion. 3) When specimen from ER reveals a lesion has moderate and massive submucosal invasion, gastrectomy is recommended regardless of size of the tumor. 4) When cancer cells remain in a stomach with mucosal or minimal submucosal depth invasion after ER, local resection is the treatment of choice instead of gastrectomy.

Copyright © 1993, Igaku-Shoin Ltd. All rights reserved.


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