INCIDENCE AND PROGNOSIS OF PARAAORTIC LYMPH-NODE METASTASIS IN GASTRIC-CANCER

Citation
Y. Nakane et al., INCIDENCE AND PROGNOSIS OF PARAAORTIC LYMPH-NODE METASTASIS IN GASTRIC-CANCER, Hepato-gastroenterology, 45(23), 1998, pp. 1901-1906
Citations number
17
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Gastroenterology & Hepatology",Surgery
Journal title
ISSN journal
0172-6390
Volume
45
Issue
23
Year of publication
1998
Pages
1901 - 1906
Database
ISI
SICI code
0172-6390(1998)45:23<1901:IAPOPL>2.0.ZU;2-Y
Abstract
BACKGROUND/AIMS: We investigated the frequency of para-aortic lymph no de involvement and evaluated the effects on survival of dissection of these lymph nodes in patients with N4 node metastasis. METHODOLOGY: On e hundred and forty nine gastric cancer patients with N4 node dissecti on were analyzed. Total gastrectomy with splenectomy or pancreatosplen ectomy was performed in 99, distal gastrectomy 48, pancreaticoduodenec tomy 3, and proximal gastrectomy with splenectomy 2. RESULTS: N4 nodal involvement was found in about 30-40% of operable patients with Borrm ann's type 3 or 4 tumor, with tumor > 8cm in size, with tumor througho ut the entire or in the upper third of the stomach, with tumor invasio n to the serosa or adjacent structures, with N2 or N3 regional lymph n ode metastasis, and with undifferentiated histological type. The survi val was quite poor. However, in patients without N3 nodal involvement or intraperito-neal free cancer cells, the survival after resection of tumor with N4 nodal involvement was relatively favorable. CONCLUSIONS : The resection of these involved lymph nodes can be expected to be be neficial in patients without extensive serosal invasion and without ex tensive lymph nodal involvement such as N3 nodes. Patients with tumor in the upper third of the stomach are appropriate candidates for N4 no de dissection.