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Lymph node distribution in patients with remnant gastric cancer

Journal of Cancer Research and Clinical Oncology volume 149, pages 2367–2374 (2023)Cite this article

Abstract

Background

Remnant gastric cancer (RGC) is defined as a carcinoma that develops in the gastric remnant from 5 years after gastrectomy, regardless of the primary gastric disease. The pattern of lymph node dissemination in these patients is not well understood. The present study aims to understand the lymph node distribution of patients with RGC in a single center.

Methods

In a total of 1380 patients with gastric cancer, between 1998 and 2020, 43 patients operated on for RGC were analyzed. The pattern of lymph node dissemination was evaluated based on the number of dissected lymph node stations, the number of positive lymph node stations, the positivity index at each analyzed station, the number of dissected lymph nodes per patient, and the positivity index per lymph node station.

Results

A mean of 13.0 ± 8.1 lymph nodes were dissected. The incidence of lymph node involvement by dissected station was higher at Stations 19, 11p, 3, 4sb and 7 (50, 40, 37.5, 36 and 31.7%, respectively). Among the positive dissected stations, Station 3 with 52.2%, 4sb with 39.1% and 4sa with 34.8% were the most affected.

Conclusion

There was no predilection for lymph node involvement when comparing the lesser and greater gastric curvature. The dissection of Stations 3, 4sb and 4sa is fundamental in surgical treatment with curative purposes. The totalization of gastrectomy with lymphadenectomy of the perigastric and supra-pancreatic stations should be the surgery of choice.

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Authors and Affiliations

  1. Department of Surgery From Hospital da Santa Casa de Misericórdia de São Paulo, Santa Casa of São Paulo Medical School, São Paulo, São Paulo, Brazil

    Alexandre Augusto Ferreira Bafutto, Osvaldo Antonio Prado Castro, Daniel Kendi Fukuhara, Wilson Rodrigues de Freitas Jr, Caio de Carvalho Zanon, Laura Lopes Claro, Marineide Carvalho, Elias Jirjoss Ilias, Carlos Alberto Malheiros & Paulo Kassab

Authors
  1. Alexandre Augusto Ferreira Bafutto
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  2. Osvaldo Antonio Prado Castro
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  3. Daniel Kendi Fukuhara
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  4. Wilson Rodrigues de Freitas Jr
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  5. Caio de Carvalho Zanon
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  6. Laura Lopes Claro
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  7. Marineide Carvalho
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  8. Elias Jirjoss Ilias
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  9. Carlos Alberto Malheiros
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  10. Paulo Kassab
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Contributions

AB and PK wrote the manuscript and prepared the figures and tables. All authors performed the treatment of the patients and collected the data.

Corresponding author

Correspondence to Alexandre Augusto Ferreira Bafutto.

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Bafutto, A.A.F., Castro, O.A.P., Fukuhara, D.K. et al. Lymph node distribution in patients with remnant gastric cancer. J Cancer Res Clin Oncol 149, 2367–2374 (2023). https://doi.org/10.1007/s00432-022-04104-z

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  • DOI: https://doi.org/10.1007/s00432-022-04104-z

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