Metastatic lymph node in gastric cancer; Is it a real distant metastasis?

BMC Cancer

Research Article

Cheol Keun Park¹  Jae Hyoung Noh²  Sung Kim²  Jae Moon Bae²  Tae Sung Sohn²  Ji Yeong An³  Hyeong Su Kim⁴  Do Hyoung Lim⁵  Seong Yoon Yi⁵  Young Suk Park⁵  Min Jae Park⁵  Ho Yeong Lim⁵  Won Ki Kang⁵  Se Hoon Park⁵  Jeeyun Lee⁵  Sang Hoon Ji⁵ 

[1] Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea;Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea;Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea;Current address: Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea;Division of Hematology and Oncology, Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Seoul, South Korea;Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea;

关键词: Gastric Cancer;    Overall Survival;    Gastric Cancer Patient;    Primary Tumor Location;    Primary Gastric Tumor;   

DOI  :  10.1186/1471-2407-10-25

 received in 2008-10-11, accepted in 2010-01-29,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundCurrently, the TNM staging system is a widely accepted method for assessing the prognosis of the disease and planning therapeutic strategies for cancer. Of the TNM system, the extent of lymph node involvement is the most important independent prognostic factor for gastric cancer. The aim of our study is to evaluate the survival and prognosis of gastric cancer patients with LN#12 or #13 involvement only and to assess the impact of anatomic regions of primary gastric tumor on survival in this particular subset of patients.MethodsAmong data of 1,008 stage IV gastric cancer patients who received curative R0 gastrectomy, a total of 79 patients with LN#12 (n = 68) and/or #13 (n = 11) were identified. All patients performed gastrectomy with D2 or D3 lymph node dissection.ResultsIn 79 patients with LN#12/13 involvement, the estimated one-, three- and five-year survival rate was 77.2%, 41.8% and 26.6% respectively. When we compared the patients with LN#12/13 involvement to those without involvement, there was no significant difference in OS (21.0 months vs. 25.0 months, respectively; P = 0.140). However, OS was significantly longer in patients with LN#12/13 involvement only than in those with M1 lymph node involvement (14.3 months; P = 0.001). There was a significant difference in survival according to anatomic locations of the primary tumor (lower to mid-body vs. high body or whole stomach): 26.5 vs. 9.2 months (P = 0.009). In Cox proportional hazard analysis, only N stage (p = 0.002) had significance to predict poor survival.ConclusionIn this study we found that curatively resected gastric cancer patients with pathologic involvement of LN #12 and/or LN #13 had favorable survival outcome, especially those with primary tumor location of mid-body to antrum. Prospective analysis of survival in gastric cancer patients with L N#12 or #13 metastasis is warranted especially with regards to primary tumor location.

【 授权许可】

Unknown   
© Lim et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.