Is extensive lymphadenectomy necessary for surgical treatment of intramucosal carcinoma of the stomach?

This study was undertaken to elucidate those histological and gross features associated with gastric carcinoma that can be adequately treated by gastrectomy with less aggressive lymphadenectomy. The frequency of metastasis to the lymph nodes was analyzed in 514 cases of resected, solitary, gastric carcinomas. The frequency of metastasis to the lymph nodes increased in proportion to the increase in the extent of penetration by the cancer into the gastric wall. Lymph nodes were not involved in cases of intramucosal carcinoma of the intestinal type, by Laurén's histological classification. By contrast, metastasis to the lymph nodes was observed in cases of intramucosal carcinoma of the diffuse type, by Laurén's classification. We conclude that extensive lymphadenectomy is not mandatory for patients with intramucosal carcinoma of the stomach of the protruded type, since the lymph nodes do not become involved in this type of gastric carcinoma.