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Evaluation of lymph node metastasis in patients with gastric cancer: a comparison of the directionality of lymph node metastasis and the total number of metastatic lymph nodes

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Abstract

Purpose

The clinical impact of the directionality of lymph node (LN) metastasis was assessed in comparison with the staging by the Japanese Classification of Gastric Carcinoma (JCGC), a numerical LN staging system.

Methods

Two hundred forty-one gastric cancer patients who were diagnosed pathologically to have LN metastasis, and 54 patients who underwent preoperative multidetector-row computed tomography (MDCT) with an image thickness of 1 mm were classified into three groups (unidirectional [Uni-], bidirectional [Bi-], and tridirectional [Tri-] groups) depending on the directionality of their LN metastasis.

Results

The prognosis of the Uni-group was better than that of the Bi- or the Tri-group when assessed on the basis of the pathological findings of metastatic LN and also the preoperative MDCT findings. The exact preoperative evaluation was 70.2 % for the directionality system and 61.7 % for the JCGC system, respectively. The stages were less frequently underestimated by the directionality system than the JCGC system (P < 0.02, 19.1 vs. 34.0 %), and the staging could be more precisely performed by both systems in combination.

Conclusions

More precise preoperative evaluation of disease stage could be obtained by the directionality system and the JCGC system in combination.

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Conflict of interest

Maki Kitagawa and co-authors have no conflict of interest.

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Authors and Affiliations

  1. Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, 602-8566, Kyoto, Japan

    Maki Kitagawa, Daisuke Ichikawa, Shuhei Komatsu, Kazuma Okamoto, Atsushi Shiozaki, Hitoshi Fujiwara, Yasutoshi Murayama, Yoshiaki Kuriu, Hisashi Ikoma, Masayoshi Nakanishi, Toshiya Ochiai, Yukihito Kokuba, Teruhisa Sonoyama & Eigo Otsuji

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  1. Maki Kitagawa
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  2. Daisuke Ichikawa
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  3. Shuhei Komatsu
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  4. Kazuma Okamoto
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  5. Atsushi Shiozaki
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  6. Hitoshi Fujiwara
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  7. Yasutoshi Murayama
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  8. Yoshiaki Kuriu
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  9. Hisashi Ikoma
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  10. Masayoshi Nakanishi
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  11. Toshiya Ochiai
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  12. Yukihito Kokuba
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  13. Teruhisa Sonoyama
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  14. Eigo Otsuji
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Corresponding author

Correspondence to Daisuke Ichikawa.

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Kitagawa, M., Ichikawa, D., Komatsu, S. et al. Evaluation of lymph node metastasis in patients with gastric cancer: a comparison of the directionality of lymph node metastasis and the total number of metastatic lymph nodes. Surg Today 43, 130–135 (2013). https://doi.org/10.1007/s00595-012-0454-8

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  • DOI: https://doi.org/10.1007/s00595-012-0454-8

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