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Pattern of Lymph Node Involvement in Proximal Gastric Cancer

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Abstract

Background

The operative methods for proximal gastric cancer differ depending on the institution, thus there is no optimal therapeutic strategy. A splenic hilum lymph node (No. 10) dissection is necessary for D2 operation for proximal gastric cancer, which means it requires splenectomy. However, unnecessary splenectomy should be avoided.

Methods

A total of 127 proximal gastric cancer cases from our institution were studied retrospectively. In addition, 1,569 cases were collected from the literature and were used as pooled data for further analysis. All cases were examined for the depth of tumor invasion and lymph node metastasis.

Results

A retrospective analysis revealed that proximal gastric cancer within submucosa (40 cases) had no N2 lymph node metastasis in our study. The 5-year overall survival of all cases was 25.2% and the disease-free survival was 23.6%. From the pooled data analysis, No. 10 lymph node metastasis was observed in 0.9% of the patients with submucosa proximal gastric cancer. Furthermore, there was no No. 4d lymph node metastasis when the depth of cancer was limited to within the subserosa.

Conclusions

Although a randomized, controlled trial concerning survival is necessary, according to this study, there is a possibility that limited resection might be accepted for proximal gastric cancer according to the depth of wall invasion.

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Acknowledgement

This study was supported by a grant-in-aid from the Ministry of Education, Culture, and Science of Japan.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto City, Kumamoto, 860-8556, Japan

    Shinji Ishikawa, Nobutomo Miyanari, Masahiko Hirota, Hiroshi Takamori & Hideo Baba

  2. Yatsushiro Regional Hospital, 2-26 Matueshiromachi, Yatushiro City, Kumamoto, 866-8660, Japan

    Shinya Shimada

Authors
  1. Shinji Ishikawa
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  2. Shinya Shimada
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  3. Nobutomo Miyanari
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  4. Masahiko Hirota
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  5. Hiroshi Takamori
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  6. Hideo Baba
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Corresponding author

Correspondence to Hideo Baba.

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Ishikawa, S., Shimada, S., Miyanari, N. et al. Pattern of Lymph Node Involvement in Proximal Gastric Cancer. World J Surg 33, 1687–1692 (2009). https://doi.org/10.1007/s00268-009-0083-6

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  • DOI: https://doi.org/10.1007/s00268-009-0083-6

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