Differentiated gastric cancers (DGC) included:
(1) well-differentiated (Grade I/III)
(2) moderately-differentiated (Grade II/III)
(3) papillary adenocarcinoma
Undifferentiated gastric cancers (UGC) included:
(1) poorly differentiated (Grade III/III)
(2) signet ring cell carcinomas
Ulcerated lesions included those with scarring from previous active ulcers.
The depth of submucosal penetration was divided into 2 groups based on the depth of invasion (microns = micrometers):
(1) if the depth is <= 500 micrometers (<= 0.5 mm) = SM1
(2) if the depth is > 500 micrometers (> 0.4 mm) = SM2
Parameters for identifying cases that can be treated locally:
(1) differentiation
(2) depth of invasion into submucosa
(3) lymphatic-vascular invasion
(4) diameter in centimeters
(5) ulceration
|
Differentia-tion
|
Depth of Invasion
|
Lymphatic-Vascular
|
Diameter in cm
|
Ulceration
|
|
DGC
|
intramucosal
|
none
|
< 3 cm
|
NA
|
|
DGC
|
intramucosal
|
none
|
NA
|
absent
|
|
DGC
|
SM1
|
none
|
< 3 cm
|
NA
|
|
UGC
|
intramucosal
|
none
|
< 3 cm
|
absent
|
where:
• 0 for depth of invasion into the submucosa indicates intramucosal.
• No lymph node metastases were observed in the patient series if any of the criteria were met. However, the 95% confidence intervals were 0 to 2.5% for the third criterion and 0 to 2.6% for the fourth criterion.
