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Published in: World Journal of Surgical Oncology 1/2018

Open Access 01-12-2018 | Research

Characteristics and survival outcomes related to the infra-pyloric lymph node status of gastric cancer patients

Authors: Wei-Han Zhang, Xiao-Hai Song, Xin-Zu Chen, Kun Yang, Kai Liu, Zhi-Xin Chen, Zong-Guang Zhou, Jian-Kun Hu

Published in: World Journal of Surgical Oncology | Issue 1/2018

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Abstract

Background

To study metastasis to the infra-pyloric (no. 6) lymph nodes and their subgroups and the related risk factors of gastric cancer patients.

Methods

Gastric cancer patients who underwent gastrectomy with complete postoperative pathological information on the no. 6 lymph node station and its subgroups from January 1, 2008, to December 31, 2011, were included. The clinicopathological characteristics and survival outcomes were analyzed.

Results

A total of 121 patients were included; they had 6.1 ± 7.7 positive lymph nodes, and 35.1 ± 14.2 lymph nodes were examined. The overall lymph node positivity rate was 67.8% (82/121) with a positivity rate of 28.1% (34/121) for the no. 6 lymph nodes. The metastasis rate was 6.6% for the no. 6a nodes, 6.6% for the no. 6b nodes, and 21.5% for the no. 6c nodes. Also, no. 8a (OR = 1.329, p = 0.017) and no. 9 (OR = 1.250, p = 0.022) nodal positivity and lower third tumor location (OR = 1.278, p = 0.001) were independent risk factors for no. 6 lymph nodal metastasis. There was a significant survival difference between patients with positive and negative no. 6 lymph nodes and patients with metastasis to other lymph node stations (p <  0.001).

Conclusions

Patients with no. 6 lymph node metastasis have poor survival outcomes. Complete infra-pyloric lymphadenectomy is necessary and crucial for gastric cancer patients.
Literature
1.
go back to reference 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 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
4.
go back to reference Shen L, Shan YS, Hu HM, Price TJ, Sirohi B, Yeh KH, Yang YH, Sano T, Yang HK, Zhang X, et al. Management of gastric cancer in Asia: resource-stratified guidelines. Lancet Oncol. 2013;14:e535–47.CrossRefPubMed Shen L, Shan YS, Hu HM, Price TJ, Sirohi B, Yeh KH, Yang YH, Sano T, Yang HK, Zhang X, et al. Management of gastric cancer in Asia: resource-stratified guidelines. Lancet Oncol. 2013;14:e535–47.CrossRefPubMed
5.
go back to reference Japanese Gastric Cancer A. Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer. 2011;14:113–23.CrossRef Japanese Gastric Cancer A. Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer. 2011;14:113–23.CrossRef
7.
go back to reference Songun I, Putter H, Kranenbarg EM, Sasako M, van de Velde CJ. Surgical treatment of gastric cancer: 15-year follow-up results of the randomised nationwide Dutch D1D2 trial. Lancet Oncol. 2010;11:439–49.CrossRefPubMed Songun I, Putter H, Kranenbarg EM, Sasako M, van de Velde CJ. Surgical treatment of gastric cancer: 15-year follow-up results of the randomised nationwide Dutch D1D2 trial. Lancet Oncol. 2010;11:439–49.CrossRefPubMed
8.
go back to reference Liu K, Yang K, Zhang W, Chen X, Chen X, Zhang B, Chen Z, Chen J, Zhao Y, Zhou Z, et al. Changes of esophagogastric junctional adenocarcinoma and gastroesophageal reflux disease among surgical patients during 1988-2012: a single-institution, high-volume experience in China. Ann Surg. 2016;263:88–95.CrossRefPubMed Liu K, Yang K, Zhang W, Chen X, Chen X, Zhang B, Chen Z, Chen J, Zhao Y, Zhou Z, et al. Changes of esophagogastric junctional adenocarcinoma and gastroesophageal reflux disease among surgical patients during 1988-2012: a single-institution, high-volume experience in China. Ann Surg. 2016;263:88–95.CrossRefPubMed
9.
go back to reference Liu CG, Lu P, Lu Y, Jin F, Xu HM, Wang SB, Chen JQ. Distribution of solitary lymph nodes in primary gastric cancer: a retrospective study and clinical implications. World J Gastroenterol. 2007;13:4776–80.CrossRefPubMedPubMedCentral Liu CG, Lu P, Lu Y, Jin F, Xu HM, Wang SB, Chen JQ. Distribution of solitary lymph nodes in primary gastric cancer: a retrospective study and clinical implications. World J Gastroenterol. 2007;13:4776–80.CrossRefPubMedPubMedCentral
10.
go back to reference Japanese Gastric Cancer A. Japanese classification of gastric carcinoma—2nd English edition. Gastric Cancer. 1998;1:10–24.CrossRef Japanese Gastric Cancer A. Japanese classification of gastric carcinoma—2nd English edition. Gastric Cancer. 1998;1:10–24.CrossRef
11.
go back to reference Japanese Gastric Cancer A. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer. 2011;14:101–12.CrossRef Japanese Gastric Cancer A. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer. 2011;14:101–12.CrossRef
12.
go back to reference Imamura T, Komatsu S, Ichikawa D, Kosuga T, Okamoto K, Konishi H, Shiozaki A, Fujiwara H, Otsuji E. Clinical characteristics of hepatoduodenal lymph node metastasis in gastric cancer. World J Gastroenterol. 2015;21:10866–73.CrossRefPubMedPubMedCentral Imamura T, Komatsu S, Ichikawa D, Kosuga T, Okamoto K, Konishi H, Shiozaki A, Fujiwara H, Otsuji E. Clinical characteristics of hepatoduodenal lymph node metastasis in gastric cancer. World J Gastroenterol. 2015;21:10866–73.CrossRefPubMedPubMedCentral
13.
go back to reference Chen QY, Huang CM, Lin JX, Zheng CH, Li P, Xie JW, Wang JB, Lu J, Yang XT. Laparoscopic infrapyloric area lymph node dissection with no. 14v enlargement for advanced lower gastric cancer in middle colic vein approach. Ann Surg Oncol. 2016;23:951.CrossRefPubMed Chen QY, Huang CM, Lin JX, Zheng CH, Li P, Xie JW, Wang JB, Lu J, Yang XT. Laparoscopic infrapyloric area lymph node dissection with no. 14v enlargement for advanced lower gastric cancer in middle colic vein approach. Ann Surg Oncol. 2016;23:951.CrossRefPubMed
14.
go back to reference Chen XZ, Zhang WH, Chen XL, Liu K, Yang K, Zhou ZG, Hu JK. Upper lesser curvature skeletonization in radical distal gastrectomy. J Surg Res. 2015;193:168–75.CrossRefPubMed Chen XZ, Zhang WH, Chen XL, Liu K, Yang K, Zhou ZG, Hu JK. Upper lesser curvature skeletonization in radical distal gastrectomy. J Surg Res. 2015;193:168–75.CrossRefPubMed
15.
go back to reference Shinohara H, Kurahashi Y, Kanaya S, Haruta S, Ueno M, Udagawa H, Sakai Y. Topographic anatomy and laparoscopic technique for dissection of no. 6 infrapyloric lymph nodes in gastric cancer surgery. Gastric Cancer. 2013;16:615–20.CrossRefPubMed Shinohara H, Kurahashi Y, Kanaya S, Haruta S, Ueno M, Udagawa H, Sakai Y. Topographic anatomy and laparoscopic technique for dissection of no. 6 infrapyloric lymph nodes in gastric cancer surgery. Gastric Cancer. 2013;16:615–20.CrossRefPubMed
16.
go back to reference Haruta S, Shinohara H, Ueno M, Udagawa H, Sakai Y, Uyama I. Anatomical considerations of the infrapyloric artery and its associated lymph nodes during laparoscopic gastric cancer surgery. Gastric Cancer. 2015;18:876–80.CrossRefPubMed Haruta S, Shinohara H, Ueno M, Udagawa H, Sakai Y, Uyama I. Anatomical considerations of the infrapyloric artery and its associated lymph nodes during laparoscopic gastric cancer surgery. Gastric Cancer. 2015;18:876–80.CrossRefPubMed
17.
go back to reference Shinohara H, Haruta S, Ohkura Y, Udagawa H, Sakai Y. Tracing dissectable layers of mesenteries overcomes embryologic restrictions when performing infrapyloric lymphadenectomy in laparoscopic gastric cancer surgery. J Am Coll Surg. 2015;220:e81–7.CrossRefPubMed Shinohara H, Haruta S, Ohkura Y, Udagawa H, Sakai Y. Tracing dissectable layers of mesenteries overcomes embryologic restrictions when performing infrapyloric lymphadenectomy in laparoscopic gastric cancer surgery. J Am Coll Surg. 2015;220:e81–7.CrossRefPubMed
18.
go back to reference Liu J, Yang K, Chen X-Z, Zhang B, Chen Z-X, Chen J-P, Hu J-K. Primary study on metastatic rate and metastasis of subpyloric lymph nodes in gastric cancer. Chin J Bases Clin General Surg. 2011;18:5. Liu J, Yang K, Chen X-Z, Zhang B, Chen Z-X, Chen J-P, Hu J-K. Primary study on metastatic rate and metastasis of subpyloric lymph nodes in gastric cancer. Chin J Bases Clin General Surg. 2011;18:5.
19.
go back to reference Zhang WH, Chen XZ, Liu K, Chen XL, Yang K, Zhang B, Chen ZX, Chen JP, Zhou ZG, Hu JK. Outcomes of surgical treatment for gastric cancer patients: 11-year experience of a Chinese high-volume hospital. Med Oncol. 2014;31:150.CrossRefPubMed Zhang WH, Chen XZ, Liu K, Chen XL, Yang K, Zhang B, Chen ZX, Chen JP, Zhou ZG, Hu JK. Outcomes of surgical treatment for gastric cancer patients: 11-year experience of a Chinese high-volume hospital. Med Oncol. 2014;31:150.CrossRefPubMed
20.
go back to reference Washington K. 7th edition of the AJCC cancer staging manual: stomach. Ann Surg Oncol. 2010;17:3077–9.CrossRefPubMed Washington K. 7th edition of the AJCC cancer staging manual: stomach. Ann Surg Oncol. 2010;17:3077–9.CrossRefPubMed
21.
go back to reference Blouhos K, Boulas KA, Tsalis K, Hatzigeorgiadis A. Right-sided bursectomy as an access plane for aesthetic resection of the posterior leaf of the lesser sac from the head of the pancreas en block with the no. 6 and 14v lymph nodes in advanced lower third gastric cancer. Surgery. 2015;158:1742.CrossRefPubMed Blouhos K, Boulas KA, Tsalis K, Hatzigeorgiadis A. Right-sided bursectomy as an access plane for aesthetic resection of the posterior leaf of the lesser sac from the head of the pancreas en block with the no. 6 and 14v lymph nodes in advanced lower third gastric cancer. Surgery. 2015;158:1742.CrossRefPubMed
22.
go back to reference Marutsuka T, Shimada S, Shiomori K, Hayashi N, Yagi Y, Yamane T, Ogawa M. Mechanisms of peritoneal metastasis after operation for non-serosa-invasive gastric carcinoma: an ultrarapid detection system for intraperitoneal free cancer cells and a prophylactic strategy for peritoneal metastasis. Clin Cancer Res. 2003;9:678–85.PubMed Marutsuka T, Shimada S, Shiomori K, Hayashi N, Yagi Y, Yamane T, Ogawa M. Mechanisms of peritoneal metastasis after operation for non-serosa-invasive gastric carcinoma: an ultrarapid detection system for intraperitoneal free cancer cells and a prophylactic strategy for peritoneal metastasis. Clin Cancer Res. 2003;9:678–85.PubMed
23.
go back to reference Han TS, Kong SH, Lee HJ, Ahn HS, Hur K, Yu J, Kim WH, Yang HK. Dissemination of free cancer cells from the gastric lumen and from perigastric lymphovascular pedicles during radical gastric cancer surgery. Ann Surg Oncol. 2011;18:2818–25.CrossRefPubMed Han TS, Kong SH, Lee HJ, Ahn HS, Hur K, Yu J, Kim WH, Yang HK. Dissemination of free cancer cells from the gastric lumen and from perigastric lymphovascular pedicles during radical gastric cancer surgery. Ann Surg Oncol. 2011;18:2818–25.CrossRefPubMed
24.
go back to reference Yang K, Choi YY, Zhang WH, Chen XZ, Song MK, Lee J, Zhang B, Chen ZX, Kim HI, Chen JP, et al. Strategies to improve treatment outcome in gastric cancer: a retrospective analysis of patients from two high-volume hospitals in Korea and China. Oncotarget. 2016;7:44660–75.PubMedPubMedCentral Yang K, Choi YY, Zhang WH, Chen XZ, Song MK, Lee J, Zhang B, Chen ZX, Kim HI, Chen JP, et al. Strategies to improve treatment outcome in gastric cancer: a retrospective analysis of patients from two high-volume hospitals in Korea and China. Oncotarget. 2016;7:44660–75.PubMedPubMedCentral
Metadata
Title
Characteristics and survival outcomes related to the infra-pyloric lymph node status of gastric cancer patients
Authors
Wei-Han Zhang
Xiao-Hai Song
Xin-Zu Chen
Kun Yang
Kai Liu
Zhi-Xin Chen
Zong-Guang Zhou
Jian-Kun Hu
Publication date
01-12-2018
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2018
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/s12957-018-1412-8

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