Purpose: Submucosal gastric carcinomas metastasize to lymph nodes
more often than the intramucosal gastric carcinomas. The objectives of this
study are to clarify the characteristics of submucosal gastric carcinomas,
especially in reference to the status of lymph node metastasis, and to
explore the possibility of a minimally invasive operation. Materials and
Methods: The clinicopathologic features of 88 patients with submucosal
gastric carcinoma, all of whom were treated with a D2+ α
gastrectomy between January 1994 and December 1999, were examined
retrospectively with respect to the status of lymph nodes. The size, depth
of submucosal invasion, histologic differentiation, location, and
macroscopic finding of the tumor were investigated in association with the
presence or the absence of lymph node metastasis. Results: Among the
88 patients, 15 (17.05%) had lymph node metastasis, and the status of
metastasis was significantly correlated with tumor size and depth of
submucosal invasion. The frequency of metastasis was 0% (0/7) of up to 1.0
㎝ and 18.5% (15/81) over 1.0 ㎝ in size (P=0.034) and 6.1% (2/33) of up to
1.0 ㎜ and 23.6% (13/55) over 1.0 ㎜ in depth of submucosal invasion
(P=0.042). Conclusion: The tumor size and depth of submucosal
invasion are useful indicators of lymph node metastasis in submucosal
gastric carcinoma. A minimally invasive operation can be applied for
submucosal gastric carcinoma up to 1.0 ㎝ in size. Further studies are
needed to limited surgery for depth of submucosal invasion.
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