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Journal of Gastrointestinal Surgery
Published in: Journal of Gastrointestinal Surgery 7/2016

01-07-2016 | Original Article

The Role of No. 10 Lymphadenectomy for Advanced Proximal Gastric Cancer Patients Without Metastasis to No. 4sa and No. 4sb Lymph Nodes

Authors: Shibo Bian, Hongqing Xi, Xiaosong Wu, Jianxin Cui, Liangang Ma, Rong Chen, Bo Wei, Lin Chen

Published in: Journal of Gastrointestinal Surgery | Issue 7/2016

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Abstract

Background

There is no consensus in the impact of No. 10 lymph node dissection (LND) for advanced proximal gastric cancer (APGC) and the status of negative No. 4sa and No. 4sb lymph nodes (No. 4s LNs) is reportedly associated with no metastasis to No. 10 LN. We aimed to evaluate the role of No. 10 LND in APGC patients with negative No. 4s LNs and the diagnostic accuracy of intraoperative pathologic examination.

Methods

We analyzed data on 727 patients with APGC who had undergone D2 lymphadenectomy with No. 10 LND (n = 380) or without No. 10 LND (n = 347) between January 2005 and December 2010. Additionally, from January to July 2014, we prospectively enrolled 48 patients with APGC and examined their No. 4s LNs intraoperatively.

Results

The negative predictive efficacy of No. 4s LN status for no metastasis to No. 10 LN was 98.09 %. Operation time, blood loss, time to first solid diet, hospital stay, and postoperative complication rate differed significantly between patients with negative No. 4s LNs who underwent No. 10 LND (n = 260) and those who did not undergo No. 10 LND (n = 243). Differences between the two groups in 5-year overall and disease-free survival were not statistically significant. The sensitivity, specificity, and accuracy of intraoperative pathological examination of LNs were 93.42, 96.56, and 95.86 %, respectively.

Conclusions

The No. 10 lymphadenectomy may not be recommended in patients with APGC who are found by intraoperative pathological examination to have negative No. 4s LNs.
Literature
1.
Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin 2015;65:87–108.CrossRefPubMed
2.
Deans C, Yeo MS, Soe MY, Shabbir A, Ti TK, So JB. Cancer of the gastric cardia is rising in incidence in an Asian population and is associated with adverse outcome. World J Surg 2011;35:617–624.CrossRefPubMed
3.
Kunisaki C, Shimada H, Nomura M, Matsuda G, Otsuka Y, Ono H, Akiyama H. Surgical outcome in patients with gastric adenocarcinoma in the upper third of the stomach. Surgery 2005;137:165–171.CrossRefPubMed
4.
Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 2015;136:E359–386.CrossRefPubMed
5.
Wang W, Zheng C, Fang C, Li P, Xie J, Lin J, Zhan Y, Li W, Chen Y, Sun X, Xu D, Li Y, Huang C, Zhou Z. Time trends of clinicopathologic features and surgical treatment for gastric cancer: Results from 2 high-volume institutions in southern China. Surgery 2015;158:1590–1597.CrossRefPubMed
6.
Kosuga T, Ichikawa D, Okamoto K, Komatsu S, Shiozaki A, Fujiwara H, Otsuji E. Survival benefits from splenic hilar lymph node dissection by splenectomy in gastric cancer patients: relative comparison of the benefits in subgroups of patients. Gastric Cancer 2011;14:172–177.CrossRefPubMed
7.
Ikeguchi M, Kaibara N. Lymph node metastasis at the splenic hilum in proximal gastric cancer. Am Surg 2004;70:645–648.PubMed
8.
Galizia G, Lieto E, De Vita F, Castellano P, Ferraraccio F, Zamboli A, Mabilia A, Auricchio A, De Sena G, De Stefano L, Cardella F, Barbarisi A, Orditura M. Modified versus standard D2 lymphadenectomy in total gastrectomy for nonjunctional gastric carcinoma with lymph node metastasis. Surgery 2015;157:285–296.CrossRefPubMed
9.
Zhu GL, Sun Z, Wang ZN, Xu YY, Huang BJ, Xu Y, Zhu Z, Xu HM. Splenic hilar lymph node metastasis independently predicts poor survival for patients with gastric cancers in the upper and/or the middle third of the stomach. J Surg Oncol 2012;105:786–792.CrossRefPubMed
10.
Shin SH, Jung H, Choi SH, An JY, Choi MG, Noh JH, Sohn TS, Bae JM, Kim S. Clinical significance of splenic hilar lymph node metastasis in proximal gastric cancer. Ann Surg Oncol 2009;16:1304–1309.CrossRefPubMed
11.
Goto H, Tokunaga M, Sugisawa N, Tanizawa Y, Bando E, Kawamura T, Niihara M, Tsubosa Y, Terashima M. Value of splenectomy in patients with Siewert type II adenocarcinoma of the esophagogastric junction. Gastric Cancer 2013;16:590–595.CrossRefPubMed
12.
Fairweather M, Jajoo K, Sainani N, Bertagnolli MM, Wang J. Accuracy of EUS and CT imaging in preoperative gastric cancer staging. J Surg Oncol 2015;111:1016–1020.CrossRefPubMed
13.
Takahashi T, Sawai K, Hagiwara A, Takahashi S, Seiki K, Tokuda H. Type-oriented therapy for gastric cancer effective for lymph node metastasis: management of lymph node metastasis using activated carbon particles adsorbing an anticancer agent. Semin Surg Oncol 1991;7:378–383.CrossRefPubMed
14.
Aoyagi K, Kouhuji K, Miyagi M, Imaizumi T, Kizaki J, Shirouzu K. Prognosis of metastatic splenic hilum lymph node in patients with gastric cancer after total gastrectomy and splenectomy. World J Hepatol 2010;2:81–86.PubMedPubMedCentral
15.
Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer 2011;14:113–123.CrossRef
16.
Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer 2011;14:101–112.CrossRef
17.
Ren G, Chen YW, Cai R, Zhang WJ, Wu XR, Jin YN. Lymph node metastasis in gastric cardiac adenocarcinoma in male patients. World J Gastroenterol 2013;19:6245–6257.CrossRefPubMedPubMedCentral
18.
Kakeji Y, Yamamoto M, Ito S, Sugiyama M, Egashira A, Saeki H, Morita M, Sakaguchi Y, Toh Y, Maehara Y. Lymph node metastasis from cancer of the esophagogastric junction, and determination of the appropriate nodal dissection. Surg Today 2012;42:351–358.CrossRefPubMed
19.
Sasada S, Ninomiya M, Nishizaki M, Harano M, Ojima Y, Matsukawa H, Aoki H, Shiozaki S, Ohno S, Takakura N. Frequency of lymph node metastasis to the splenic hilus and effect of splenectomy in proximal gastric cancer. Anticancer Res 2009;29:3347–3351.PubMed
20.
Nashimoto A, Yabusaki H, Matsuki A. The significance of splenectomy for advanced proximal gastric cancer. Int J Surg Oncol 2012;2012:301530.PubMedPubMedCentral
21.
Di Leo A, Marrelli D, Roviello F, Bernini M, Minicozzi A, Giacopuzzi S, Pedrazzani C, Baiocchi LG, de Manzoni G. Lymph node involvement in gastric cancer for different tumor sites and T stage: Italian Research Group for Gastric Cancer (IRGGC) experience. J Gastrointest Surg 2007;11:1146–1153.CrossRefPubMed
22.
Kampschoer GH, Maruyama K, van de Velde CJ, Sasako M, Kinoshita T, Okabayashi K. Computer analysis in making preoperative decisions: a rational approach to lymph node dissection in gastric cancer patients. Br J Surg 1989;76:905–908.CrossRefPubMed
23.
Sasako M, McCulloch P, Kinoshita T, Maruyama K. New method to evaluate the therapeutic value of lymph node dissection for gastric cancer. Br J Surg 1995;82:346–351.CrossRefPubMed
24.
Yang K, Zhang WH, Chen XZ, Chen XL, Zhang B, Chen ZX, Zhou ZG, Hu JK. Survival benefit and safety of no. 10 lymphadenectomy for gastric cancer patients with total gastrectomy. Medicine (Baltimore) 2014;93:e158.CrossRef
25.
Dresner SM, Lamb PJ, Bennett MK, Hayes N, Griffin SM. The pattern of metastatic lymph node dissemination from adenocarcinoma of the esophagogastric junction. Surgery 2001;129:103–109.CrossRefPubMed
26.
Shimizu Y, Takeuchi H, Sakakura Y, Saikawa Y, Nakahara T, Mukai M, Kitajima M, Kitagawa Y. Molecular detection of sentinel node micrometastases in patients with clinical N0 gastric carcinoma with real-time multiplex reverse transcription-polymerase chain reaction assay. Ann Surg Oncol 2012;19:469–477.CrossRefPubMed
27.
Can MF, Yagci G, Cetiner S. Systematic review of studies investigating sentinel node navigation surgery and lymphatic mapping for gastric cancer. J Laparoendosc Adv Surg Tech A 2013;23:651–662.CrossRefPubMed
28.
Tavares A, Monteiro-Soares M, Viveiros F, Maciel Barbosa J, Dinis-Ribeiro M. Occult Tumor Cells in Lymph Nodes of Patients with Gastric Cancer: A Systematic Review on Their Prevalence and Predictive Role. Oncology 2015;89:245–254.CrossRefPubMed
29.
Ishii K, Kinami S, Funaki K, Fujita H, Ninomiya I, Fushida S, Fujimura T, Nishimura G, Kayahara M. Detection of sentinel and non-sentinel lymph node micrometastases by complete serial sectioning and immunohistochemical analysis for gastric cancer. J Exp Clin Cancer Res 2008;27:7.CrossRefPubMedPubMedCentral
30.
Maruyama K, Katai H. Surgical treatment of gastric cancer in Japan, trend from standardization to individualization. Chirurgia (Bucur) 2014;109:722–730.
Metadata
Title
The Role of No. 10 Lymphadenectomy for Advanced Proximal Gastric Cancer Patients Without Metastasis to No. 4sa and No. 4sb Lymph Nodes
Authors
Shibo Bian
Hongqing Xi
Xiaosong Wu
Jianxin Cui
Liangang Ma
Rong Chen
Bo Wei
Lin Chen
Publication date
01-07-2016
Publisher
Springer US
Published in
Journal of Gastrointestinal Surgery / Issue 7/2016
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-016-3113-3

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