Superficial spreading type of early gastric cancer.

To determine the clinicopathological features of the superficial spreading type of early gastric cancer, which is defined as early gastric cancer in which the product of the longest diameter of the tumour and the diameter perpendicular to it is greater than 25 cm2, they were compared retrospectively with those of small-sized early gastric cancers, which are defined as tumours smaller than 2 x 2 cm2. The superficial spreading type accounted for 5.46% of all early gastric cancers. The distinguishing histopathological features of superficial spreading lesions were: a diffuse type of cancer, submucosal invasion and advanced lymph node involvement. Of the 32 patients with superficial spreading lesions, eight underwent an additional resection as a continuance of the first gastrectomy, because of an indistinct tumour margin. More extensive lymph node dissection was also performed on the group with superficial spreading lesions. There was no difference in 5 year survival rate between the two groups (superficial spreading type, 96.0% vs small-sized type, 95.1%). The most appropriate treatment for superficial spreading lesions is a wide surgical resection with extensive lymph node dissection.