Comparison of five systems for staging lymph node metastasis in gastric cancer

Yu, Wansik; Choi, Gyu Seog; Whang, Ilwoo; Suh, In Soo

doi:10.1046/j.1365-2168.1997.00515.x

Cited by 32 publications

(24 citation statements)

References 10 publications

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“…These observations are in agreement with those of Siewert et al [13], Watanabe et al [9]and Maehara et al [10], and support the concept that lymphatic invasion of proximal gastric carcinomas is more frequent than that of distal carcinomas [13, 24, 25]. The prognostic relevance of venous invasion and lymph node metastases has been reported in the literature [9, 10, 13, 15, 26, 27, 28, 29, 30, 31]. …”

Section: Discussionsupporting

confidence: 83%

Clinicopathologic Profiles and Prognosis of Gastric Carcinomas from the Cardia, Fundus/Body and Antrum

et al. 2001

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Background/Aims: The putative influence of tumor location on the biologic behavior of gastric carcinomas remains controversial. The aim of this study was to investigate if carcinomas arising in the three types of gastric mucosa (cardia, fundus/body and antrum) have different clinical and pathologic profiles and carry a different prognosis. Methods: Three hundred and two patients with cardia or gastric carcinoma resected between 1984 and 1996 were retrospectively studied. Cases were divided in three groups according to tumor location: cardia (n = 80); fundus/body (n = 60); antrum (n = 162). The three groups were crosstabulated with clinic and pathologic parameters, such as age, sex, macroscopy, histology, desmoplasia, tumor size, depth of tumor wall penetration, nodal status, venous invasion and stage. Survival rates were calculated for the three locations according to the aforementioned parameters. Univariate survival analysis and Cox regression were performed for each location. Results: Cases from the cardia and fundus/body were similar and distinct from antrum cases according to macroscopy, tumor size, depth of wall penetration, venous invasion, nodal status and stage. Cases from fundus/body were similar to antrum cases and distinct from cardia cases according to gender and Laurén’s classification. An overall difference in survival between the three locations was observed (p = 0.006). Cumulative survival was better for patients with carcinomas in the antrum than in the cardia (p = 0.04) and in the fundus/body (p = 0.003); no significant differences were observed in survival between cardia and fundus/body carcinoma cases. Cox regression identified stage and venous invasion as prognostic factors for patients with carcinomas in the three locations. In the group of cardia tumors, older patients had a worse outcome and in the group of fundus/body carcinomas, large tumors were associated with a poorer survival. Conclusions: Our results show that cardia carcinoma and antrum carcinoma are distinct gastric carcinoma entities whereas fundus/body carcinoma shares some characteristics from both entities.

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Section: Discussionsupporting

confidence: 83%

Clinicopathologic Profiles and Prognosis of Gastric Carcinomas from the Cardia, Fundus/Body and Antrum

et al. 2001

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“…[1][2][3][4][5][7][8][9][10][11][12][13][14] In our previous study, 9 we clarified that the total number of positive lymph nodes (1-6 vs. Ն7) was the significant prognostic indicator, and the anatomical distribution of lymph node metastasis was not an independent prognostic factor in node-positive gastric cancer. Recent studies demonstrated that the TNM classification (UICC/AJCC, 5th edition, 1997) based on the total number of positive lymph nodes was a better staging system compared with the Japanese classification based on the anatomical level of lymph node metastasis.…”

Section: Discussionmentioning

confidence: 98%

“…1,2 Both the level and number of lymph node metastases are useful for predicting the survival of patients, 3,4 and there are several staging systems for lymph node metastasis of gastric cancer. 5 Anatomical distribution of regional lymph nodes is determined by the Japanese Gastric Cancer Association (JGCA), 6 but the numbering (No. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] and grouping (Group 1-3) depends on the location and extension of tumors and is too complicated to be used routinely at community hospitals worldwide.…”

mentioning

confidence: 99%

Most Important Lymph Node Information in Gastric Cancer: Multivariate Prognostic Study

Adachi

Shiraishi²,

Suematsu³

et al. 2000

Ann Surg Oncol

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“…NR intervals that correlated more strictly with prognosis have not been universally established yet and many cut-offs have been proposed. 7,30,32 The minimum number of nodes, if it exists, below which the NR maintains its value and correlation with prognosis, has yet to be defined. Due to the paucity of data in this study, we were unable to perform such an analysis.…”

Section: Discussionmentioning

confidence: 99%