Background/aims: This article discusses the results of study of the impact of tumor size on the lymph node metastasis of early distal gastric cancer (EDGC). The understanding of such impact will provide the basis for the selection of optimal lymph node dissection and scope.
Methodology: Between April 1995 and August 2006, 146 patients of EDGC underwent primary surgery and were included in the study. We selected the optimal cut-off point of tumor size via ROC curve. We then investigated the relationship between the tumor size and the lymph node metastasis for each group.
Results: The optimal cut-off point of the tumor size was 23 mm. Metastasis only occurred in No.1, 3-7 lymph nodes for patients in small-diameter group (SDG) or those in large-diameter group (LDG) with intramucosal carcinoma. For patients in the LDG with submucosal carcinoma, metastasis occurred in No.1, 3-7, 8a, 9 and 12a lymph nodes.
Conclusions: For EDGC patients, when tumor was <23 mm or intramucosal cancer was ≥23 mm, metastasis tended to occur only in No.1, 3-7 lymph nodes. But if submucosal cancer was ≥23 mm, metastasis occurred in all of No. 1, 3-7 and No. 8a, 9 and 12a lymph nodes.