BACKGROUND: The aim of lymphadenectomy is to clear all the metastatic nodes achieving a complete removal of the tumor; nevertheless, its role in gastric cancer has been very much debated. MATERIALS AND METHODS: The frequency of node metastasis in each lymphatic station according to the International Gastric Cancer Association, was studied in 545 patients who underwent D2 or D3 lymphadenectomy from June 1988 to December 2002. RESULTS: Upper third early cancers have shown an involvement of N2 celiac nodes in 25%. In advanced cancers, there was a high frequency of metastasis in the right gastroepiploic (from 10% in T2 to 50% in T4) and in the paraaortic nodes (26% in T2, 32% in T3, 38 % in T4). N3 left paracardial nodes involvement was observed in an important share of middle third tumors (17% in T3, 36% in T4). Splenic hilum nodes metastasis were common in T3 and T4 cancers located in the upper (39%) and middle (17%) stomach. N2 nodal involvement was frequent in lower third advanced cancers. Metastasis in M left paracardial and short gastric nodes were observed in a small percentage of cases. CONCLUSION: Given the nodal diffusion in our gastric cancer patients, extended lymphadenectomy is still a rationale to obtain radical resection.
BACKGROUND: The aim of lymphadenectomy is to clear all the metastatic nodes achieving a complete removal of the tumor; nevertheless, its role in gastric cancer has been very much debated. MATERIALS AND METHODS: The frequency of node metastasis in each lymphatic station according to the International Gastric Cancer Association, was studied in 545 patients who underwent D2 or D3 lymphadenectomy from June 1988 to December 2002. RESULTS: Upper third early cancers have shown an involvement of N2 celiac nodes in 25%. In advanced cancers, there was a high frequency of metastasis in the right gastroepiploic (from 10% in T2 to 50% in T4) and in the paraaortic nodes (26% in T2, 32% in T3, 38 % in T4). N3 left paracardial nodes involvement was observed in an important share of middle third tumors (17% in T3, 36% in T4). Splenic hilum nodes metastasis were common in T3 and T4 cancers located in the upper (39%) and middle (17%) stomach. N2 nodal involvement was frequent in lower third advanced cancers. Metastasis in M left paracardial and short gastric nodes were observed in a small percentage of cases. CONCLUSION: Given the nodal diffusion in our gastric cancerpatients, extended lymphadenectomy is still a rationale to obtain radical resection.
Authors: J J Bonenkamp; J Hermans; M Sasako; C J van de Velde; K Welvaart; I Songun; S Meyer; J T Plukker; P Van Elk; H Obertop; D J Gouma; J J van Lanschot; C W Taat; P W de Graaf; M F von Meyenfeldt; H Tilanus Journal: N Engl J Med Date: 1999-03-25 Impact factor: 91.245
Authors: Giovanni de Manzoni; Paolo Morgagni; Franco Roviello; Alberto Di Leo; Luca Saragoni; Daniele Marrelli; Alfredo Guglielmi; Alfonso Carli; Secondo Folli; Claudio Cordiano Journal: Gastric Cancer Date: 1998-03 Impact factor: 7.370
Authors: H Furukawa; M Hiratsuka; S Imaoka; O Ishikawa; T Kabuto; Y Sasaki; M Kameyama; H Ohigashi; H Nakano; T Yasuda Journal: Ann Surg Oncol Date: 1998-06 Impact factor: 5.344
Authors: A Cuschieri; S Weeden; J Fielding; J Bancewicz; J Craven; V Joypaul; M Sydes; P Fayers Journal: Br J Cancer Date: 1999-03 Impact factor: 7.640
Authors: Bang Wool Eom; Young-Woo Kim; Sang Eok Lee; Keun Won Ryu; Jun Ho Lee; Hong Man Yoon; Soo-Jeong Cho; Myeong-Cherl Kook; Soo Jin Kim Journal: Surg Endosc Date: 2012-05-31 Impact factor: 4.584
Authors: Giovanni De Manzoni; Gian Luca Baiocchi; Massimo Framarini; Maurizio De Giuli; Domenico D'Ugo; Alberto Marchet; Donato Nitti; Daniele Marrelli; Paolo Morgagni; Andrea Rinnovati; Riccardo Rosati; Franco Roviello; Rosaldo Allieta; Stefano Berti; Umberto Bracale; Patrizio Capelli; Angelo Cavicchi; Natale Di Martino; Annibale Donini; Angelo Filippini; Gianfranco Francioni; Marco Frascio; Alfredo Garofalo; Stefano Maria Giulini; Giovanni Battista Grassi; Paolo Innocenti; Antonio Martino; Gualtiero Mazzocconi; Lorenzo Mazzola; Severino Montemurro; Nicola Palasciano; Gianni Pantuso; Heinrich Pernthaler; Roberto Petri; Diego Piazza; Rosario Sacco; Giovanni Sgroi; Carlo Staudacher; Michele Testa; Carlo Vallicelli; Nereo Vettoretto; Costantino Zingaretti; Lorenzo Capussotti; Mario Morino; Giorgio Maria Verdecchia Journal: Updates Surg Date: 2014-03
Authors: Do Hyoung Lim; Hyeong Su Kim; Young Suk Park; Jeeyun Lee; Se Hoon Park; Ho Yeong Lim; Sang Hoon Ji; Min Jae Park; Seong Yoon Yi; Ji Yeong An; Tae Sung Sohn; Jae Hyoung Noh; Jae Moon Bae; Sung Kim; Cheol Keun Park; Won Ki Kang Journal: BMC Cancer Date: 2010-01-29 Impact factor: 4.430