Lymph node metastasis in patients with adenocarcinoma of gastric cardia

作者：Liang-Shun Wang, Chew-Wun Wu, Maw-Jye Hsieh, Huei-Jyh Fahn, Min-Hsiung Huang, K. Y. Chien · 发表于：Cancer · 年份：1993 · DOI：10.1002/1097-0142(19930315)71:6<1948::aid-cncr2820710604>3.0.co;2-s · 被引用次数：44 · 研究领域：Gastric Cancer Management and Outcomes、Esophageal Cancer Research and Treatment、Esophageal and GI Pathology

BACKGROUND AND METHODS: Prospectively, a consecutive series of 42 patients undergoing extended radical total gastrectomies (R 3/4 lymph node dissection) for adenocarcinoma of the gastric cardia from January 1988 to June 1991 were studied. The aims of this study were to evaluate the status of lymph node metastasis and the relationship between the frequency of nodal involvement and the extent of the primary tumor invasion. The Japanese criteria was used for postoperative staging. RESULTS: The incidence of operative morbidity and mortality in the series were 40.5% and 9.5%, respectively. Twenty-two (52%) of the patients had lymph node metastasis. For those patients, the most common sites of nodal involvement were the lesser curvature (72.7%), pericardiac (68.2%), left gastric artery (45.5%), left greater curvature (31.8%), splenic artery (31.8%), and the hilum (22.7%), inferior paraesophageal (18.2%), and diaphragmatic (18.2%) regions. Only one skip lymph node metastasis was discovered. In addition, no lymph node metastasis was found in the following areas: hepatoduodenal ligaments, mesenteric root, right paraadrenal, and subcardial lymph nodes. CONCLUSIONS: The study's results demonstrate that there seemed to a correlation among the status of lymph node metastasis, tumor size, and the depth of tumor invasion. However, the depth of tumor invasion appears to be a more important factor than tumor size in influencing the status of lymph node metastasis. The local recurrence rate wa...