Surgical treatment of early gastric cancer.

Our investigation comprises 778 cases of resection for early gastric cancer (27.4% of all stomach resections). The rate of lymph node metastasis was 1.2% in m (mucosal cancer) group, 3.3% in sm (submucosal cancer) 1 group and 22.6% in sm 2 group. In sm 2 group, lymph node extirpation of R2 is essential. The five year survival rates were 94.1% in the m group, 94.1% in the sm 1 group and 94.1 in the sm 2 group, respectively. The rate of recurrence of m group was 0.6%, against 3.3% for sm 2 group. Sm 2 with well-differentiated, n(+) and Borrmann types are high risk groups. Adjuvant chemotherapy is necessary to obtain improved surgical results for the high risk groups. Cases of early gastric cancer exist which are beyond help by surgical means.