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Patterns of regional recurrence after curative D2 resection for stage III (N3) gastric cancer: implications for postoperative radiotherapy

Authors
 Jee Suk Chang  ;  Joon Seok Lim  ;  Sung Hoon Noh  ;  Woo Jin Hyung  ;  Ji Yeong An  ;  Yong Chan Lee  ;  Sun Young Rha  ;  Chang Geol Lee  ;  Woong Sub Koom 
Citation
 Radiotherapy and Oncology, Vol.104(3) : 367-373, 2012 
Journal Title
 Radiotherapy and Oncology 
ISSN
 0167-8140 
Issue Date
2012
Abstract
BACKGROUND AND PURPOSE: To analyze patterns of regional recurrence after curative gastrectomy and D2 lymph node dissection in patients with stage III (N3) gastric cancer. MATERIALS AND METHODS: Between 2004 and 2008, 2918 patients with primary gastric cancer underwent D2 resection at a single institution. A retrospective review was performed on 382 patients in stage III with N3 disease. Of these, 357 patients (93.5%) received adjuvant chemotherapy. None of the patients received pre- or postoperative radiotherapy. RESULTS: Median follow-up was 56.3 months. The 5-year regional failure free-survival (RFFS) rate was 63.6%. Regional failure (RF) as any component of first recurrence occurred in 91 patients (23.8%), with isolated regional failure occurring in 49 (12.8%). The most commonly involved lymph nodes were the No. 16b, No. 16a, No. 12, No. 14, No. 13, and No. 9 nodes. RFFS was adversely affected by advanced nodal stage (N3b vs. N3a). The 5-year progression-free survival rate was 32.1% and overall survival was 41.5%. CONCLUSION: The most prevalent nodal recurrence in patients with advanced gastric cancer was in the nodal basin outside the D2 dissection field. Our findings may help physicians construct a lymph node target volume for radiation treatment of gastric cancer after D2 dissection.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/91784
DOI
10.1016/j.radonc.2012.08.017
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
Yonsei Authors
금웅섭(Koom, Woong Sub) ; 노성훈(Noh, Sung Hoon) ; 라선영(Rha, Sun Young) ; 이용찬(Lee, Yong Chan) ; 이창걸(Lee, Chang Geol) ; 임준석(Lim, Joon Seok) ; 장지석(Chang, Jee Suk Paul) ; 형우진(Hyung, Woo Jin)
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Full Text
http://www.sciencedirect.com/science/article/pii/S0167814012003684
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