Skip to main content
PMC home page
Annals of Surgery logoLink to Annals of Surgery
. 1989 Nov;210(5):596–602. doi: 10.1097/00000658-198911000-00005

Lymph node metastases of gastric cancer. General pattern in 1931 patients.

K Maruyama 1, P Gunvén 1, K Okabayashi 1, M Sasako 1, T Kinoshita 1
PMCID: PMC1357792  PMID: 2818028

Abstract

The incidence of metastases from gastric adenocarcinoma to various regional lymph node stations was studied after meticulous node dissection and correlated to survival in 1931 resected patients. The incidence of metastases increased with deeper tumor invasion into the stomach wall. Deposits were most common in some perigastric node stations, and their distribution was clearly related to the location of the tumor. Some nonperigastric node stations also were frequently involved, e.g., those around the left gastric artery or in the splenic hilum, and may be considered primary draining nodes. Skip metastases to distant nodes were found in a few per cent of perigastric node-negative patients. Deposits in nodes around the middle colic artery, but not in any other upper abdominal node stations, were incompatible with 5-year survival rates. The analysis favors a so-called R2 or more extensive resection for cancers invading beyond the submucosa.

Full text

PDF
596

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BERRY R. E., ROTTSCHAFER W. The lymphatic spread of cancer of the stomach observed in operative specimens removed by radical surgery including total pancreatectomy. Surg Gynecol Obstet. 1957 Mar;104(3):269–279. [PubMed] [Google Scholar]
  2. Cantrell E. G. The importance of lymph-nodes in the assessment of gastric carcinoma at operation. Br J Surg. 1971 May;58(5):384–386. doi: 10.1002/bjs.1800580518. [DOI] [PubMed] [Google Scholar]
  3. Dent D. M., Madden M. V., Price S. K. Randomized comparison of R1 and R2 gastrectomy for gastric carcinoma. Br J Surg. 1988 Feb;75(2):110–112. doi: 10.1002/bjs.1800750206. [DOI] [PubMed] [Google Scholar]
  4. Diggory R. T., Cuschieri A. R2/3 gastrectomy for gastric carcinoma: an audited experience of a consecutive series. Br J Surg. 1985 Feb;72(2):146–148. doi: 10.1002/bjs.1800720226. [DOI] [PubMed] [Google Scholar]
  5. Fisher E. R., Palekar A., Rockette H., Redmond C., Fisher B. Pathologic findings from the National Surgical Adjuvant Breast Project (Protocol No. 4). V. Significance of axillary nodal micro- and macrometastases. Cancer. 1978 Oct;42(4):2032–2038. doi: 10.1002/1097-0142(197810)42:4<2032::aid-cncr2820420453>3.0.co;2-o. [DOI] [PubMed] [Google Scholar]
  6. Gall F. P., Hermanek P. New aspects in the surgical treatment of gastric carcinoma--a comparative study of 1636 patients operated on between 1969 and 1982. Eur J Surg Oncol. 1985 Sep;11(3):219–225. [PubMed] [Google Scholar]
  7. Gilbertsen V. A. Results of treatment of stomach cancer. An appraisal of efforts for more extensive surgery and a rort of 1,983 cases. Cancer. 1969 Jun;23(6):1305–1308. doi: 10.1002/1097-0142(196906)23:6<1305::aid-cncr2820230610>3.0.co;2-0. [DOI] [PubMed] [Google Scholar]
  8. Gunderson L. L., Sosin H. Adenocarcinoma of the stomach: areas of failure in a re-operation series (second or symptomatic look) clinicopathologic correlation and implications for adjuvant therapy. Int J Radiat Oncol Biol Phys. 1982 Jan;8(1):1–11. doi: 10.1016/0360-3016(82)90377-7. [DOI] [PubMed] [Google Scholar]
  9. LAUREN P. THE TWO HISTOLOGICAL MAIN TYPES OF GASTRIC CARCINOMA: DIFFUSE AND SO-CALLED INTESTINAL-TYPE CARCINOMA. AN ATTEMPT AT A HISTO-CLINICAL CLASSIFICATION. Acta Pathol Microbiol Scand. 1965;64:31–49. doi: 10.1111/apm.1965.64.1.31. [DOI] [PubMed] [Google Scholar]
  10. Maruyama K., Okabayashi K., Kinoshita T. Progress in gastric cancer surgery in Japan and its limits of radicality. World J Surg. 1987 Aug;11(4):418–425. doi: 10.1007/BF01655804. [DOI] [PubMed] [Google Scholar]
  11. Mine M., Majima S., Harada M., Etani S. End results of gastrectomy for gastric cancer: effect of extensive lymph node dissection. Surgery. 1970 Nov;68(5):753–758. [PubMed] [Google Scholar]
  12. Papachristou D. N., Fortner J. G. Local recurrence of gastric adenocarcinomas after gastrectomy. J Surg Oncol. 1981;18(1):47–53. doi: 10.1002/jso.2930180108. [DOI] [PubMed] [Google Scholar]
  13. ReMine W. H., Gomes M. M., Dockerty M. B. Long-term survival (10 to 56 years) after surgery for carcinoma of the stomach. Am J Surg. 1969 Feb;117(2):177–184. doi: 10.1016/0002-9610(69)90302-x. [DOI] [PubMed] [Google Scholar]
  14. SUNDERLAND D. A., McNEER G., ORTEGA L. G., PEARCE L. S. The lymphatic spread of gastric cancer. Cancer. 1953 Sep;6(5):987–996. doi: 10.1002/1097-0142(195309)6:5<987::aid-cncr2820060518>3.0.co;2-3. [DOI] [PubMed] [Google Scholar]
  15. Shiu M. H., Papacristou D. N., Kosloff C., Eliopoulos G. Selection of operative procedure for adenocarcinoma of the midstomach. Twenty years' experience with implications for future treatment strategy. Ann Surg. 1980 Dec;192(6):730–737. doi: 10.1097/00000658-198012000-00007. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. de Aretxabala X., Konishi K., Yonemura Y., Ueno K., Yagi M., Noguchi M., Miwa K., Miyazaki I. Node dissection in gastric cancer. Br J Surg. 1987 Sep;74(9):770–773. doi: 10.1002/bjs.1800740904. [DOI] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES