[Early cancer of the stomach: pattern of lymphatic metastasizing and its influence on surgical approach].

Results of surgical treatment of 156 patients were analyzed. There were no metastases to the lymph nodes in patients with invasion of mucous membrane only. In patients with invasion of the tumor into a submucous layer regional metastases were revealed in 18 (19%) cases. Number of affected lymph nodes varied from 1 to 7 (2.7, on the average). Metastases to 1 lymph node were revealed in 9 (50%) patients, to 2-3 nodes -- in 5 patients, to 5-7 nodes -- in 4 patients. In 14.78% patients metastases were only to perigastric lymph nodes, in 4 cases -- to nodes of the second level (N2). Invasion of the tumor into submucous layer, location and size of the tumor were the main factor of risk of lymphatic cancer spread. Frequency of lymphatic cancer spread does not exceed 10% in any variant. In patients with proximal tumor, infiltrative growth and size more than 4 cm, tumor lymphatic metastases are diagnosed in each third person. It is concluded that gastrectomy or distal subtotal resection of the stomach with modified D2 lymphatic dissection is the method of choice in treatment of patients with invasion of stomach cancer into submucous layer.