Solitary Lymph Node Metastasis in Gastric Cancer |
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Authors: | Chen Li Sungsoo Kim Ji Fu Lai Sung Jin Oh Woo Jin Hyung Won Hyuk Choi Seung Ho Choi Sung Hoon Noh |
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Institution: | (1) Department of Surgery, Yonsei University College of Medicine, 134 Shinchon-dong Seodaemun-gu, Seoul, 120-752, South Korea;(2) Cancer Metastasis Research Center, Yonsei University College of Medicine, Seoul, 120-752, South Korea;(3) Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, 120-752, South Korea;(4) Department of Surgery, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025, China;(5) Department of Surgical Oncology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, 310016, China |
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Abstract: | The feasibility and diagnostic reliability of sentinel node (SN) biopsy for gastric cancer are still controversial. We studied
the clinicopathological features and localization of solitary lymph node metastasis (SLM) in gastric cancer to provide useful
information for use of the SN concept in gastric cancer. From 2000 to 2004, 3,267 patients with gastric cancer underwent D2
radical gastrectomy. The clinicopathological features of 195 patients with histologically proven SLM and the distribution
of metastasized nodes were assessed. The incidence of SLM was 6.0% in all cases. Compared with the node-negative patients,
significant differences were observed in age, tumor size, depth of invasion, and surgical type. The cumulative 5-year survival
rate of patients with SLM was 80.5%, which was significantly lower than 90.2% for node-negative patients (P < 0.001). Of patients with SLM, 82.6% had it in the perigastric node area (N1), and the other 17.4% patients had skip metastasis
in the N2-N3 nodes. Perigastric nodes were the most common first sites of drainage from the tumor, making them the main targets
of the operative SN mapping procedure. Due to the higher than expected incidence of skip metastasis in gastric cancer, D2
lymphadenectomy should be performed until the reliability of SN navigation surgery is validated in multicenter prospective
clinical trials. |
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Keywords: | Solitary lymph node metastasis Gastric cancer Sentinel node |
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