Top

Published in:

01-08-2009 | Gastrointestinal

Stomach cancer: prevalence and significance of neck nodal metastases on sonography

Authors: Kunwar S. S. Bhatia, James F. Griffith, Anil T. Ahuja

Published in: European Radiology | Issue 8/2009

Abstract

The aim of this study was to determine the frequency of metastatic neck nodes detected using sonography in patients with stomach cancer at presentation according to primary subsite and to assess the effect of metastatic neck node detection on tumour staging. Imaging and histological records of 233 patients diagnosed with stomach cancer were reviewed. All patients underwent neck ultrasound at presentation with ultrasound-guided fine needle aspiration for cytology (FNAC) of sonographically abnormal neck nodes. Abnormal nodes were classified positive or negative for metastases based on the FNAC result. Clinical records were also reviewed for evidence of subsequent neck nodal metastases. Sonographically abnormal neck nodes were present in 14/233 (6.0%) patients; 7 were reactive and 7 were metastatic based on FNAC findings and clinical follow-up. Overall, 7/233 (3.0%) patients with stomach cancer had nodal metastases, although tumour stage was altered in only 2/233 (0.9%) patients; 57% of metastatic nodes were impalpable. Nodal metastases from gastric cardia tumours (6%) were more common than from the body (2%) or antrum (3%). Neck node metastases are uncommon in stomach cancer at presentation, are usually associated with extensive intra-abdominal metastatic spread, and adversely influence tumour staging in only a small minority of patients.

Greene FL, Page DL, Fleming ID et al (2002) AJCC cancer staging manual, 6th edn. Springer-Verlag, New York

Schwartz SI, Spencer FC, Galloway AC, Shires TG, Daly JM, Fischer JE (2001) Principles of surgery, 7th edn. McGraw-Hill, New York

Akiyama H, Tsurumaru M, Udagawa H, Kajiyama Y (1994) Radical lymph node dissection for cancer of the thoracic esophagus. Ann Surg 220:364–372; discussion 372–363PubMedCrossRef

van Overhagen H, Lameris JS, Berger MY et al (1991) Supraclavicular lymph node metastases in carcinoma of the esophagus and gastroesophageal junction: assessment with CT, US, and US-guided fine-needle aspiration biopsy. Radiology 179:155–158PubMed

van Overhagen H, Brakel K, Heijenbrok MW et al (2004) Metastases in supraclavicular lymph nodes in lung cancer: assessment with palpation, US, and CT. Radiology 232:75–80PubMedCrossRef

Atula TS, Varpula MJ, Kurki TJ, Klemi PJ, Grenman R (1997) Assessment of cervical lymph node status in head and neck cancer patients: palpation, computed tomography and low field magnetic resonance imaging compared with ultrasound-guided fine-needle aspiration cytology. Eur J Radiol 25:152–161PubMedCrossRef

Tachimori Y, Kato H, Watanabe H, Yamaguchi H (1994) Neck ultrasonography for thoracic esophageal carcinoma. Ann Thorac Surg 57:1180–1183PubMedCrossRef

Bruneton JN, Roux P, Caramella E, Demard F, Vallicioni J, Chauvel P (1984) Ear, nose, and throat cancer: ultrasound diagnosis of metastasis to cervical lymph nodes. Radiology 152:771–773PubMed

Ariji Y, Kimura Y, Hayashi N et al (1998) Power Doppler sonography of cervical lymph nodes in patients with head and neck cancer. AJNR Am J Neuroradiol 19:303–307PubMed

10.

van den Brekel MW, Castelijns JA, Stel HV et al (1991) Occult metastatic neck disease: detection with US and US-guided fine-needle aspiration cytology. Radiology 180:457–461PubMed

11.

van den Brekel MW, Reitsma LC, Quak JJ et al (1999) Sonographically guided aspiration cytology of neck nodes for selection of treatment and follow-up in patients with N0 head and neck cancer. AJNR Am J Neuroradiol 20:1727–1731PubMed

12.

Ying M, Ahuja A, Metreweli C (1998) Diagnostic accuracy of sonographic criteria for evaluation of cervical lymphadenopathy. J Ultrasound Med 17:437–445PubMed

13.

Griffith JF, Chan AC, Chow LT et al (1999) Assessing chemotherapy response of squamous cell oesophageal carcinoma with spiral CT. Br J Radiol 72:678–684PubMed

14.

Vassallo P, Wernecke K, Roos N, Peters PE (1992) Differentiation of benign from malignant superficial lymphadenopathy: the role of high-resolution US. Radiology 183:215–220PubMed

15.

Griffith JF, Chan AC, Ahuja AT et al (2000) Neck ultrasound in staging squamous oesophageal carcinoma—a high yield technique. Clin Radiol 55:696–701PubMedCrossRef

16.

Doldi SB, Lattuada E, Zappa MA et al (1998) Ultrasonographic evaluation of the cervical lymph nodes in preoperative staging of esophageal neoplasms. Abdom Imaging 23:275–277PubMedCrossRef

17.

Natsugoe S, Yoshinaka H, Shimada M et al (1999) Assessment of cervical lymph node metastasis in esophageal carcinoma using ultrasonography. Ann Surg 229:62–66PubMedCrossRef

18.

Kew MC (1991) Virchow–Troisier’s lymph node in hepatocellular carcinoma. J Clin Gastroenterol 13:217–219PubMedCrossRef

19.

Langford RJ, Daudia AT, Malins TJ (1999) A morphological study of the thoracic duct at the jugulo-subclavian junction. J Craniomaxillofac Surg 27:100–104PubMed

20.

van Vliet EP, Steyerberg EW, Eijkemans MJ, Kuipers EJ, Siersema PD (2007) Detection of distant metastases in patients with oesophageal or gastric cardia cancer: a diagnostic decision analysis. Br J Cancer 97:868–876PubMed

21.

Devaney KO, Rinaldo A, Ferlito A (2007) Micrometastases in cervical lymph nodes from patients with squamous carcinoma of the head and neck: should they be actively sought? Maybe. Am J Otolaryngol 28:271–274PubMedCrossRef

22.

Shores CG, Yin X, Funkhouser W, Yarbrough W (2004) Clinical evaluation of a new molecular method for detection of micrometastases in head and neck squamous cell carcinoma. Arch Otolaryngol Head Neck Surg 130:937–942PubMedCrossRef

23.

Rinaldo A, Devaney KO, Ferlito A (2004) Immunohistochemical studies in the identification of lymph node micrometastases in patients with squamous cell carcinoma of the head and neck. ORL J Otorhinolaryngol Relat Spec 66:38–41PubMed

24.

Jose J, Coatesworth AP, MacLennan K (2003) Cervical metastases in upper aerodigestive tract squamous cell carcinoma: histopathologic analysis and reporting. Head Neck 25:194–197PubMedCrossRef

25.

Barrera JE, Miller ME, Said S, Jafek BW, Campana JP, Shroyer KR (2003) Detection of occult cervical micrometastases in patients with head and neck squamous cell cancer. Laryngoscope 113:892–896PubMedCrossRef

26.

Knappe M, Louw M, Gregor RT (2000) Ultrasonography-guided fine-needle aspiration for the assessment of cervical metastases. Arch Otolaryngol Head Neck Surg 126:1091–1096PubMed

27.

van den Brekel MW, Stel HV, van der Valk P, van der Waal I, Meyer CJ, Snow GB (1992) Micrometastases from squamous cell carcinoma in neck dissection specimens. Eur Arch Otorhinolaryngol 249:349–353PubMedCrossRef

Title: Stomach cancer: prevalence and significance of neck nodal metastases on sonography
Authors: Kunwar S. S. Bhatia
James F. Griffith
Anil T. Ahuja
Publication date: 01-08-2009
Publisher: Springer-Verlag
Published in: European Radiology / Issue 8/2009
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-009-1372-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Stomach cancer: prevalence and significance of neck nodal metastases on sonography

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 8/2009

Should previous mammograms be digitised in the transition to digital mammography?

Quantitative ultrasound in the assessment of skeletal status

Node-by-node correlation between MR and PET/CT in patients with uterine cervical cancer: diffusion-weighted imaging versus size-based criteria on T2WI

Primary uncleansed 2D versus primary electronically cleansed 3D in limited bowel preparation CT-colonography. Is there a difference for novices and experienced readers?

Dual-energy CT head bone and hard plaque removal for quantification of calcified carotid stenosis: utility and comparison with digital subtraction angiography

Hydatid disease of right ventricle and pulmonary arteries: a rare cause of pulmonary embolism—computed tomography and magnetic resonance imaging findings (2009: 5b)