Lymph Node Metastases of Gastric Cancer

Maruyama, Keiichi; Gunvén, Peter; Okabayashi, Kan; Sasako, M.; Kinoshita, Taira

doi:10.1097/00000658-198911000-00005

Cited by 418 publications

(110 citation statements)

References 13 publications

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“…The abdominal compartment (field 1) encompasses all nodal stations limited inferiorly by the pancreas, superiorly by the esophageal hiatus, and laterally by the splenic hilum and the hepatoduodenal ligament. Removal of additional lymph nodes (stations 13 and 16) and the technique of pancreas-preserving lymphadenectomy of the splenic vessels may be required in type III tumors [18,19]. The mediastinal compartment (field 2) includes three different levels of lymphadenectomy: "standard", i.e., removal of paraesophageal, subcarinal, and right parabronchial nodes; "extended" (2-field one), i.e., removal of right paratracheal, brachiocephalic, and right recurrential nodes; "total" (2-field two), i.e., removal also of the left recurrential nodes.…”

Section: Discussionmentioning

confidence: 99%

Results of surgical therapy in patients with adenocarcinoma of the esophagus and cardia

et al. 1999

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Abstract:Background. Adenocarcinoma of the esophagus and cardia is a challenging disease for the surgeon. Delay in diagnosis, nodal involvement, and incompleteness of resection have an adverse effect on long-term prognosis. Efforts are currently oriented to identify patients who may benefit from extensive resection. Methods. Between November 1992 and May 1998, 218 patients with histologically proven adenocarcinoma of the distal esophagus or cardia were referred to our Department. In 6 patients (10.2%) cancer was discovered during endoscopic surveillance for Barrett's metaplasia. Overall, 147 patients (67%) underwent resection. An Ivor-Lewis approach was used in 121 patients; of these, 51 underwent an extended mediastinal lymph node dissection. Results. Median cumulative survival was 25.9 ؎ 3.1 months in patients undergoing resection, and 7 ؎ 1.3 months in patients having palliation (P < 0.01). Survival was significantly higher in patients with negative nodes than in those with lymph node metastases (54 ؎ 12.9 versus 17 ؎ 2.8 months; P < 0.01). Six of the 51 patients (11.8%) undergoing extended lymphadenectomy had metastatic upper mediastinal nodes. Additional serial sections and immunohistochemistry were performed in 46 patients. In 6 of 18 patients (33.3%) with negative nodes at conventional hematoxylin-eosin examination, immunohistochemistry demonstrated micrometastases in the lesser curvature, paracardial, peripancreatic, or lower mediastinal nodes. Three of these patients had recurrent disease within the first year of follow-up. Conclusions. Early diagnosis remains the prerequisite for curative treatment of adenocarcinoma of the esophagus and cardia. Endoscopic surveillance appears to be warranted in patients with Barrett's metaplasia. When a curative resection is attempted, extended lymphadenectomy improves tumor staging and may prevent local recurrences. Serial sections and immunohistochemistry provide additional accuracy in the staging of the disease and may prove useful to select patients for adjuvant therapy. Offprint requests to:A. Peracchia

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Section: Discussionmentioning

confidence: 99%

Results of surgical therapy in patients with adenocarcinoma of the esophagus and cardia

et al. 1999

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“…Lymph node metastasis is the most reliable prognostic factor in gastric cancers when the depth of invasion is similar (Maruyama et al, 1987;Hioki et al, 1990;Maehara et al, 1992;Sano et al, 1992 Recent advances in diagnostic techniques allowed us to determine preoperative and intraoperative staging of gastric cancer (Tatsuta et al, 1982;Yasuda et al, 1986;Tio et al, 1989). In particular, endoscopic ultrasonography and intraoperative histological examination are useful for more objective determination of the depth of invasion for gastric cancer, which is strongly correlated with patients' survival time (Maruyama et al, 1989;Kitamura et al, 1996c). Preoperative and intraoperative assessment of the depth of invasion is imperative for determining the surgical procedure: limited or extensive lymph node dissection.…”

Section: Methodsmentioning

confidence: 99%

Early gastric cancer mimicking advanced gastric cancer

Kitamura

Yamaguchi²,

Nishida³

et al. 1997

Br J Cancer

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Summary The clinicopathological features of 37 early gastric cancers mimicking advanced gastric cancer were reviewed retrospectively, and were compared with 596 other early gastric cancers and 126 mp gastric cancers, defined as gastric cancer invading the muscularis propria of the stomach. A greater tumour size (P < 0.005), submucosal invasion (P < 0.005), lymph node and lymph vessel invasion (P < 0.005) and vascular invasion (P < 0.025) were found more frequently in early gastric cancers mimicking advanced gastric cancers than in other early gastric cancers. There were no significant differences in the clinicopathological findings between early gastric cancers mimicking advanced gastric cancers and mp gastric cancers. Patients with early gastric cancers mimicking advanced gastric cancers showed a lower survival rate than patients with other early gastric cancers, but a higher survival than those with mp gastric cancers. The macroscopic appearance of an advanced gastric cancer was an indicator of massive submucosal invasion and lymph node metastasis in early gastric cancer. As early gastric cancers mimicking advanced gastric cancers showed similar clinicopathological findings to mp gastric cancers, these cancers should be treated as mp gastric cancers.

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“…The practice of gastrectomy with extended lymphadenectomy for gastric cancer was established in Japan and provides the foundation for effective treatment of this disease 13. In 1989, Maruyama et al 14. published the largest and most detailed work concerning lymph node metastasis in gastric cancer, and then later demonstrated the effectiveness of extended lymphadenectomy for gastric cancer 13.…”

Section: Gastric Surgerymentioning

confidence: 99%

Gastroenterological surgery in Japan: The past, the present and the future

Colvin

Mizushima

Eguchi

et al. 2017

Annals of Gastroent Surgery

138

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In the last two centuries, there has been remarkable progress in the field of gastroenterological surgery, including the curative resection of cancers, replacement of failed organs through transplantation, increased safety of undergoing major surgeries and decreased operative morbidity through developments in minimal access surgery. Japan has very much been at the forefront of these advances, as is evident from the present review, from advancing the surgical management of gastric cancer to the pioneering work in live‐donor transplantation. This review also highlights many instances where surgical management of the same pathologies has evolved differently between Japan and the West. It is encouraging that many procedures established in Japan are eventually taken up by the West, often after rigorous assessment affirming the quality and applicability of such techniques. In Japan, many of the crucial issues in gastroenterological surgery are increasingly addressed through large multi‐institutional prospective control trials, ensuring that Japanese surgeons continue to contribute to the advances in gastroenterological surgery.

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Lymph Node Metastases of Gastric Cancer

Cited by 418 publications

References 13 publications

Results of surgical therapy in patients with adenocarcinoma of the esophagus and cardia

Results of surgical therapy in patients with adenocarcinoma of the esophagus and cardia

Early gastric cancer mimicking advanced gastric cancer

Gastroenterological surgery in Japan: The past, the present and the future

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