Infrapyloric lymph node metastasis pattern in middle/lower gastric cancer: an exploratory analysis of a multicenter prospective observational study (IPA-ORIGIN)

作者：Tasiken Baheti, Rulin Miao, Gang Zhao, Daguang Wang, Fenglin Liu, Jiang Yu, Shuangyi Ren, Kai Ye, Su Yan, Kun Yang, Weidong Zang, Lin Fan, Bin Liang, Jun Cai, Weihua Fu, Wei Wang, Zheng-Rong Tiger Li, Zhao-Jian Niu, Jun You, Xingfeng Qiu, Song Wu, Lu Zang · 发表于：Chinese Medical Journal · 年份：2020 · DOI：10.1097/cm9.0000000000000995 · 被引用次数：2 · 研究领域：Gastric Cancer Management and Outcomes、Metastasis and carcinoma case studies、Gastrointestinal Tumor Research and Treatment

To the Editor: Gastric cancer is one of the most common cancers in China. It is mainly found in the middle/lower part of the stomach,[1] where it commonly metastasizes from the infrapyloric lymph node (No. 6). Previous studies reported that the risk of No. 6 lymph node metastasis was different based on tumor locations. In lower gastric cancer patients, the metastatic rate of No. 6 lymph node can reach up to 18.7%, and in upper gastric cancer, the rate is merely 1.9%.[2] The distance between the primary tumor and the pylorus was proved to be related to No. 6 lymph node metastasis. However, most of the studies were retrospective and their lymph nodes dissection's quality control was controversial. The infrapyloric artery (IPA)-Origin study was a prospective multicenter observational study that aimed at clarifying the origin of infrapyloric artery (ClinicalTrials.gov, NCT03071237).[3] In this study, the surgical quality control was strict, and photos or videos of the No. 6 lymph node area were recorded in all patients. Our study is an exploratory analysis based on the IPA-Origin study and that explores the pattern and risk factors of No. 6 lymph node metastasis, which may provide bases for future clinical diagnoses and treatments. The IPA-Origin study contained 34 gastrointestinal surgery centers in China and a total of 429 patients were enrolled. In this study, 424 cases were successfully collected, and 39 cases were excluded due to post-operative pathological non-malignant dia...