A Pathological Study of the Indication for Para-aortic Lymph Node Dissection in Advanced Gastric Cancer

• Published in: Nippon Shokaki Geka Gakkai zasshi Vol. 23; no. 8; pp. 2033 - 2038
• Main Authors: Segawa, Masataka, Yonemura, Yutaka, Matsumoto, Hisashi, Kimura, Hironobu, Kamata, Touru, Fujimura, Takashi, Ooymama, Shigekazu, Sugiyama, Kazuo, Nishimura, Genichi, Kosaka, Takeo, Yamaguchi, Akio, Miwa, Kouichi, Miyazaki, Itsuo
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society of Gastroenterological Surgery 1990
• Subjects: metastasis of para-aortic lymph node in advanced gastric cancer; R4-lymphadenectomy
• ISSN: 0386-9768; 1348-9372
• DOI: 10.5833/jjgs.23.2033

87 cases of advanced gastric cancer were reviewed to find the answer to whether para-aortic lymph node dissection (R4-lymphadenectomy) improved the prognosis in patients with advanced gastric cancer and to determine the indications for R4-lymphadenectomy. 24 cases of the 87 cases were found to be n4. In 11 cases of n4 cases not judged N4, micrometastasis was found in the No.16 lymph node. In all 24 cases (n4 cases), metastasis was frequent in group 2 lymph nodes, especially Nos. 7, 9, 10, and 11. Furthermore, by measeuring the depth of cancerous invasion, the rate of positivity of prognostic serosal factor (ps (+)) in the n4 cases was found to be 79%, which was higher than that in non n4 cases (p<0.01). It is difficult to diagnose to be n4 during the operation, but it may be concluded that in cases of advanced gastric cancer diagnosed as ps (+) or with metasta sis to group 2 lymph nodes, R4-lymph-adenectomy should be performed to remove micrometastsis in No.16.