Study of Lymphatic Metastatic Patterns in Gastric Carcinoma According to Tumor Location.

Abstract

Summary: A total of 226 cases of advanced gastric cancer which occupied only one third of the stomach were analyzed in order to clarify whether and how lymphatic spread differed according to the tumor location and gross type of tumor. Out of the 226 patients, 45 cases had tumor in the upper third, 74 cases had it in the middle third, and 107 cases had it in the lower third of the stomach. The incidence of lymph node metastasis was found to be much higher for the tumors located in the lesser curvature (51.6%), greater curvature and posterior wall (54.4%), as compared to the tumors located in the anterior wall (28.0%). The tumors located in the upper third of the stomach did not show any metastasis in the N3 node, while the tumors located in the lower third of the stomach did not show any metastasis in the left cardial nodes, short gastric nodes, and the nodes along the left gastroepiploic vessels. Similarly, the tumors from the middle third of the stomach did not invade the left cardial nodes.

Pattern of lymph node metastases in gastric cancer: a side-study of the multicenter LOGICA-trial

“…D2-lymphadenectomy is generally considered standard treatment for resectable gastric cancer [7,10]. However, it has been suggested that the required extent of lymphadenectomy could vary per patient as the pattern of LN metastases may depend on tumor location and characteristics [11][12][13][14][15][16][17][18][19][20]. For instance, the Japanese Gastric Cancer Association (JGCA) recommends D1+-lymphadenectomy (without resecting stations 11 and 12a; Fig.…”

“…Several studies investigated the pattern of LN metastases from gastric cancer following D2-/D3-lymphadenectomy [11][12][13][14][15][16][17][18][19][20]. Results showed that development of LN metastases is correlated with higher cT-stage and diffuse type tumors, and that location of locoregional LN metastases is related to primary tumor location [11][12][13][14][15][16][17][18][19][20].…”

“…Several studies investigated the pattern of LN metastases from gastric cancer following D2-/D3-lymphadenectomy [11][12][13][14][15][16][17][18][19][20]. Results showed that development of LN metastases is correlated with higher cT-stage and diffuse type tumors, and that location of locoregional LN metastases is related to primary tumor location [11][12][13][14][15][16][17][18][19][20]. However, these studies were retrospective and conducted decades ago, and mainly included Asian patients treated without neoadjuvant chemotherapy (NAC) [11][12][13][14][15][16][17][18][19][20].…”

“…Results showed that development of LN metastases is correlated with higher cT-stage and diffuse type tumors, and that location of locoregional LN metastases is related to primary tumor location [11][12][13][14][15][16][17][18][19][20]. However, these studies were retrospective and conducted decades ago, and mainly included Asian patients treated without neoadjuvant chemotherapy (NAC) [11][12][13][14][15][16][17][18][19][20]. Up to present day, neither prospective studies nor neoadjuvantly treated patients were investigated regarding this topic.…”

130: Pattern of Lymph Node Metastases in Gastric Cancer—a Side-Study of the Multicenter Logica-Trial

“…D2-lymphadenectomy is generally considered standard treatment for resectable gastric cancer [7,10]. However, it has been suggested that the required extent of lymphadenectomy could vary per patient as the pattern of LN metastases may depend on tumor location and characteristics [11][12][13][14][15][16][17][18][19][20]. For instance, the Japanese Gastric Cancer Association (JGCA) recommends D1+-lymphadenectomy (without resecting stations 11 and 12a; Fig.…”