Lymph node metastasis in cancer of the middle-third stomach: Criteria for treatment with a pylorus-preserving gastrectomy

Citation
Y. Kodera et al., Lymph node metastasis in cancer of the middle-third stomach: Criteria for treatment with a pylorus-preserving gastrectomy, SURG TODAY, 31(3), 2001, pp. 196-203
Citations number
23
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Surgery
Journal title
SURGERY TODAY-THE JAPANESE JOURNAL OF SURGERY
ISSN journal
0941-1291 → ACNP
Volume
31
Issue
3
Year of publication
2001
Pages
196 - 203
Database
ISI
SICI code
0941-1291(2001)31:3<196:LNMICO>2.0.ZU;2-T
Abstract
A retrospective study was conducted to establish the criteria for performin g a pylorus-preserving gastrectomy. This study was performed on 491 patient s who had cancer of the middle-third stomach and had been curatively treate d with a distal gastrectomy. The incidence of node metastasis for each lymp h node station (the group of regional lymph nodes which have been anatomica lly defined and classified by the Japanese Classification of Gastric Carcin oma) was evaluated with reference to the depth of invasion, tumor size, and circumferential location, to show any significant correlations with an inc rease in tumor diameter or in the depth of tumor invasion. The benefits of resecting each station was then evaluated based on the incidence of metasta sis to each station and the rate of long-term survivors among those with me tastasis to each station. The benefit was substantial for the lymph nodes a long the lesser curvature, along the right gastroepiploic artery, and at th e base of the left gastric artery, while the advantages were almost negligi ble for the suprapyloric nodes and right paracardial nodes. In conclusion, carcinoma that fulfills either of the following conditions may thus be indi cated to undergo a pylorus-preserving gastrectomy: (i) restricted to a dept h of m of sm1, (ii) a depth of sm2 or mp with a diameter of less than 2 cm, (ii) a depth of sm2 or mp and located in the greater curvature.