Prognostic Significance of Morphological Distribution of Metastatic Foci in Lymph Nodes with Gastric Cancer

Abstract

Background/Aims: The morphological distribution of tumor cells in metastatic lymph nodes has been investigated in positive sentinel lymph nodes in several solid cancers. The aim of this study was to clarify the effect of the distribution of metastatic foci in lymph nodes on the prognosis in gastric cancer. Methods: The distribution of metastatic foci in the 100 node-positive patients who had undergone curative gastrectomy were classified into two groups: (1) massive type, in which the tumor occupied the entire lymph node, and (2) non-massive type, in which the tumor did not occupy the entire lymph node. Results: There were 38 patients in the massive type group and 62 patients in the non-massive type group. The 10-year survival rate was significantly poorer in the massive type group (p = 0.001). Multivariate analysis showed that distributional type and nodal status were independent prognostic factors. UICC N stage was subcategorized by distributional type, and survival was shown to be significantly worse in the massive type in the N1 group (p = 0.035). Conclusion: It seems necessary to take the morphological distribution of metastatic foci into consideration when dealing with node-positive patients who had received curative resection for gastric cancer.

Gastric carcinoma: stage migration by immunohistochemically detected lymph node micrometastases

“…Contrary to that, Fukagawa et al [22,43] detected no influence on survival in two different studies, neither for mi-positive nor for ITC-positive patients with pT2N0M0 gastric carcinoma and D2 dissection. Another approach to LN evaluation was made by Nakamura et al [44] who classified metastatic LN into a massive type with tumor occupation of the entire LN and a non-massive type with only partial LN infiltration; the 10-year-survival was significantly poorer in the massive type group. In the present study LN mi, which would clearly be regarded as the non-massive type, showed an Fig.…”