Erschienen in:
01.09.2007
Lymph Node Involvement in Gastric Cancer for Different Tumor Sites and T Stage
Italian Research Group for Gastric Cancer (IRGGC) Experience
verfasst von:
Alberto Di Leo, Daniele Marrelli, Franco Roviello, Marco Bernini, AnnaMaria Minicozzi, Simone Giacopuzzi, Corrado Pedrazzani, Luca Gian Baiocchi, Giovanni de Manzoni
Erschienen in:
Journal of Gastrointestinal Surgery
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Ausgabe 9/2007
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Abstract
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.