Should all the N3 lymph nodes group metastasis be regarded as distant metastasis (M1) in curatively resected gastric cancer.
10.3349/ymj.1992.33.2.143
- Author:
Hyun Cheol CHUNG
1
;
Ho Yeong LIM
;
Eun Hee KOH
;
Joo Hang KIM
;
Jae Kyung ROH
;
In Suh PARK
;
Jin Sik MIN
;
Kyung Sik LEE
;
Jung Koo YOUN
;
Byung Soo KIM
;
Kyi Beom LEE
Author Information
1. Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
N3;
distant metastasis;
extended lymphaednectomy
- MeSH:
Adult;
Chemotherapy, Adjuvant;
Female;
Human;
Lymphatic Metastasis;
Male;
Middle Age;
Stomach Neoplasms/mortality/*pathology/surgery;
Survival Rate
- From:Yonsei Medical Journal
1992;33(2):143-152
- CountryRepublic of Korea
- Language:English
-
Abstract:
Recently, metastasis to N3 lymph nodes group was regarded as distant metastasis by the new TNM staging system due to poor overall survival. However, the 5-year overall survival rate of patients with metastasis to N3 groups was 34.5% after curative surgery. Moreover, in patients with metastasis to lymph node subgroups of #12, #13, #14, the overall 5-year survival rate increased upto 47.2% after curative resection and adjuvant chemotherapy. This was similar to that of the patients with metastasis to N1 and N2 lymph nodes groups. But in these highly tumor burden states, no survival benefit was found with the addition of immunotherapy to chemotherapy as we achieved in stage II and III. Therefore, we suggest that, at least, metastasis to #12, #13, #14 lymph nodes subgroups should not be categorized as a distant metastasis. And in these situations, active curative radical surgery with extended lymphadenectomy and adjuvant chemotherapy are recommended.