Clinical characteristics of gastric cancer with metastasis to the lymph node along the superior mesenteric vein (14v).

Abstract:

AIM:We investigated the clinical significance of metastasis to the lymph node (LN) along the superior mesenteric vein (14v) in gastric cancer. METHODS:A retrospective study of 2,513 gastrectomy patients with a 14v dissection was done using the Ganken Igan Database. RESULTS:The incidence of 14v metastasis correlated with tumor location, depth of tumor invasion, regional LN metastases, peritoneal metastasis, peritoneal cytology-positive, hepatic metastasis and postoperative recurrence (p < 0.01). Metastases to the infra-pyloric LN (6), supra-pyloric LN (5) and left para-cardial LN (2) were independent variables affecting 14v metastasis (p < 0.05), and the 6 status was a useful predictive factor for a 14v-negative status with a low false-negative rate (1.9%). The patients with 14v metastasis after curative surgery demonstrated a significantly lower survival rate than those without (5-year overall survival rate; 11.3 vs. 60.2%, p < 0.0001). In them, LN around the abdominal aorta (16)-positive group showed a significantly lower survival rate than the negative group (p < 0.05). CONCLUSIONS:Advanced gastric cancer with invasion to the lower stomach often metastasizes to 14v, and the 6 status can predict 14v negative. Most patients with 14v metastasis have a poor prognosis, similar to those with systemic metastasis, although some such patients may benefit from a curative dissection.

journal_name

Dig Surg

journal_title

Digestive surgery

authors

Masuda TA,Sakaguchi Y,Toh Y,Aoki Y,Harimoto N,Taomoto J,Ikeda O,Ohga T,Adachi E,Okamura T

doi

10.1159/000165382

subject

Has Abstract

pub_date

2008-01-01 00:00:00

pages

351-8

issue

5

eissn

0253-4886

issn

1421-9883

pii

000165382

journal_volume

25

pub_type

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