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Erschienen in: Annals of Surgical Oncology 8/2011

01.08.2011 | Gastrointestinal Oncology

Tumor Site and Perigastric Nodal Status are the Most Important Predictors of Para-Aortic Nodal Involvement in Advanced Gastric Cancer

verfasst von: Giovanni de Manzoni, MD, Alberto Di Leo, MD, Franco Roviello, MD, Daniele Marrelli, MD, Simone Giacopuzzi, MD, Anna Maria Minicozzi, MD, Giuseppe Verlato, MD

Erschienen in: Annals of Surgical Oncology | Ausgabe 8/2011

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Abstract

Background

This study was designed to identify pathological predictors of para-aortic nodal invasion in advanced gastric cancer.

Methods

Between 1990 and 2007, 294 patients with advanced gastric cancer underwent gastrectomy with D2 lymphadenectomy + para-aortic nodal dissection in Siena and Verona, Italy.

Results

Forty-seven (16%) patients had para-aortic node metastases. Of these, 91%, 88%, and 74%, respectively, also had metastases at stations No. 3, No. 1, and No. 7. Para-aortic node metastases were never observed when stations No. 1 and No. 3 were both negative. Patients were divided into three groups, according to the risk of para-aortic node invasion: (1) high-risk group (n = 24, 8.2%), presenting a 42% risk and comprising T3/T4 cancers with mixed/nonintestinal histology, arising from the upper third; (2) low-risk group (n = 138, 46.9%), presenting a 0–10% risk and including middle-lower third tumors—either T2 irrespective of histology, or T3/T4 with intestinal histology; (3) intermediate-risk group, comprising all other patients (n = 132, 44.9%). Their risk ranged between 16% and 30%, but increased up to 21–37.5% after excluding 33 patients with negative No. 1 and No. 3 stations.

Conclusions

The combination of tumor site, histology, and T stage with perigastric nodal status allowed identification of patients at higher risk of para-aortic nodal invasion who could benefit from para-aortic nodal dissection.
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Metadaten
Titel
Tumor Site and Perigastric Nodal Status are the Most Important Predictors of Para-Aortic Nodal Involvement in Advanced Gastric Cancer
verfasst von
Giovanni de Manzoni, MD
Alberto Di Leo, MD
Franco Roviello, MD
Daniele Marrelli, MD
Simone Giacopuzzi, MD
Anna Maria Minicozzi, MD
Giuseppe Verlato, MD
Publikationsdatum
01.08.2011
Verlag
Springer-Verlag
Erschienen in
Annals of Surgical Oncology / Ausgabe 8/2011
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-010-1547-5

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