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Metastatic lymph node in gastric cancer; is it a real distant metastasis?

 Do Hyoung Lim  ;  Hyeong Su Kim  ;  Young Suk Park  ;  Jeeyun Lee  ;  Se Hoon Park  ;  Ho Yeong Lim  ;  Sang Hoon Ji  ;  Min Jae Park  ;  Seong Yoon Yi  ;  Ji Yeong An  ;  Tae Sung Sohn  ;  Jae Hyoung Noh  ;  Jae Moon Bae  ;  Sung Kim  ;  Cheol Keun Park  ;  Won Ki Kang 
 BMC CANCER, Vol.10 : 25, 2010 
Journal Title
Issue Date
Adenocarcinoma/pathology ; Adult ; Aged ; Cell Line, Tumor ; Female ; Gastrectomy/methods ; Humans ; Lymph Nodes/pathology* ; Lymphatic Metastasis* ; Male ; Middle Aged ; Neoplasm Metastasis ; Prognosis ; Proportional Hazards Models ; Stomach Neoplasms/pathology* ; Treatment Outcome
Gastric Cancer ; Overall Survival ; Gastric Cancer Patient ; Primary Tumor Location ; Primary Gastric Tumor
BACKGROUND: Currently, the TNM staging system is a widely accepted method for assessing the prognosis of the disease and planning therapeutic strategies for cancer. Of the TNM system, the extent of lymph node involvement is the most important independent prognostic factor for gastric cancer. The aim of our study is to evaluate the survival and prognosis of gastric cancer patients with LN#12 or #13 involvement only and to assess the impact of anatomic regions of primary gastric tumor on survival in this particular subset of patients. METHODS: Among data of 1,008 stage IV gastric cancer patients who received curative R0 gastrectomy, a total of 79 patients with LN#12 (n = 68) and/or #13 (n = 11) were identified. All patients performed gastrectomy with D2 or D3 lymph node dissection. RESULTS: In 79 patients with LN#12/13 involvement, the estimated one-, three- and five-year survival rate was 77.2%, 41.8% and 26.6% respectively. When we compared the patients with LN#12/13 involvement to those without involvement, there was no significant difference in OS (21.0 months vs. 25.0 months, respectively; P = 0.140). However, OS was significantly longer in patients with LN#12/13 involvement only than in those with M1 lymph node involvement (14.3 months; P = 0.001). There was a significant difference in survival according to anatomic locations of the primary tumor (lower to mid-body vs. high body or whole stomach): 26.5 vs. 9.2 months (P = 0.009). In Cox proportional hazard analysis, only N stage (p = 0.002) had significance to predict poor survival. CONCLUSION: In this study we found that curatively resected gastric cancer patients with pathologic involvement of LN #12 and/or LN #13 had favorable survival outcome, especially those with primary tumor location of mid-body to antrum. Prospective analysis of survival in gastric cancer patients with L N#12 or #13 metastasis is warranted especially with regards to primary tumor location
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
An, Ji Yeong(안지영)
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