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KMID : 0914820110110020086
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Journal of the Korean Gastric Cancer Association
2011 Volume.11 No. 2 p.86 ~ p.93
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Clinical Significance of the Pattern of Lymph Node Metastasis Depending on the Location of Gastric Cancer
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Han Ki-Bin
Jang You-Jin
Kim Jong-Han
Park Sung-Soo
Park Seong-Heum
Kim Seung-Joo
Mok Young-Jae
Kim Chong-Suk
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Abstract
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Purpose: When performing a laparoscopic assisted gastrectomy, a function-preserving gastrectomy is performed depending on the location of the primary gastric cancer. This study examined the incidence of lymph node metastasis by the lymph node station number by tumor location to determine the optimal extent of the lymph node dissection.
Materials and Methods: The subjects consisted of 1,510 patients diagnosed with gastric cancer who underwent a gastrectomy between 1996 and 2005. The patients were divided into three groups: upper, middle and lower third, depending on the location of the primary tumor. The lymph node metastasis patterns were analyzed in the total and early gastric cancer patients.
Results: In all patients, lymph node station numbers 1, 2, 3, 7, 10 and 11 metastases were dominant in the cancer originating in the upper third, whereas station numbers 4, 5, 6 and 8 were dominant in the lower third. In early gastric cancer patients, the station number of lymph nodes with a metastasis did not show a significant difference in stage pT1a disease. On the other hand, a metastasis in lymph node station number 6 was dominant in stage pT1b disease that originated in the lower third of the stomach.
Conclusions: When performing a laparoscopic-assisted gastrectomy for early gastric cancer, a limited lymphadenectomy is considered adequate during a function-preserving gastrectomy in mucosal (T1a) cancer. On the other hand, for submucosal (T1b) cancer, a number 6 node dissection should be performed when performing a pylorus preserving gastrectomy.
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KEYWORD
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Stomach neoplasms, Tumor location, Lymphatic metastasis
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