[Indication of extended radical operation for gastric antrum cancer assessed by rules of lymphatic metastasis].

Study on the lymphatic metastasis rule of 83 cases of gastric antrum carcinoma showed overall lymphatic metastasis rate (LMR) was 80.7% (67/83) and overall metastasis degree was 22.9% (i. e. 440 positive in the 1926 lymph nodes). There is no significant difference (P greater than 0.05) in LMR in the second line (N2) for the lesions with various biological features. Growth mode and histological type have the greatest influence on LMR in the third line (N3). N3 in the infiltration type and poorly or undifferentiated type is obviously higher than that in the localized and well-differentiated types (P less than 0.01). In view of the results, we conclude that extended radical operation (R3) should not be used as a routine operation for gastric cancer and be selectively carried out referring to the biological features of the tumor. In general, stage I gastric cancer is not indicated for R3; stages II and III are absolute indications; stage IV is the relative indication, i. e. group T1-4a N3M0 can be indicated; a part of T4b can also be treated by R3 resecting en bloc the involved organs but group M1 would miss the radical treatment. Besides, total gastrectomy or combined resection of spleen, body and tail of the pancreas should not be done routinely for gastric antrum cancer. They are to be performed according to the degree of involvement of the gastric body and metastasis in the lymph node groups 1, 2 and 3, 4.