Comparative Study between Gastric Cancer with Metastasis to Paraaortic Node and Stage IV Gastric Cancer with Distant Metastasis.
- Author:
Yong Gu OH
1
;
Hyeong Rok KIM
;
Dong Yi KIM
;
Young Jin KIM
Author Information
1. Department of Surgery, Chonnam University College of Medicine.
- Publication Type:Comparative Study ; Original Article
- Keywords:
Gastric cancer;
Paraaortic node, Liver metastasis;
Peritoneal metastasis
- MeSH:
Adenocarcinoma;
Classification;
DNA;
Humans;
Japan;
Jeollanam-do;
Liver;
Lymph Nodes;
Male;
Neoplasm Metastasis*;
Ploidies;
Sex Distribution;
Stomach;
Stomach Neoplasms*;
Survival Rate
- From:Journal of the Korean Surgical Society
1999;57(Suppl):990-995
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Extended radical dissection of gastric cancer offers a more accurate stage, and complete removal of the metastatic lymph nodes raises the rate of curability. It has been thought for a long time that gastric cancer with paraaortic lymph-node metastasis is impossible to cure. However, with several reports of long-term survival of cases with paraaortic lymph-node metastasis, recently the procedure of paraaortic node dissection has become prevalent in Japan. METHODS: The study group was comprised with 348 patients of stage IV gastric cancer from among total of 2,015 patients with gastric cancer who had undergone gastric resection between 1979 and 1997 at the Department of Surgery, Chonnam University Hospital. Thirty-eight (38) of the 348 patients were paraaortic lymph-node positive (group I), 233 presented peritoneal metastasis (group II), and the remaining 77 presented liver metastasis (group III). The following factors were taken into consideration: age, sex, size of tumor, histopathologic classification, Borrmann type, location of tumor, DNA ploidy pattern, and survival rate. RESULTS: 1) In sex distribution, the third group (III) showed a statistically significant male predominence compared with the other groups (I=63.2%, II=67.4%, III=87.0%) (p<0.01). 2) In histopathologic classifications, well-differentiated tubular adenocarcinomas were more common in group III (I=10.5%, II=6.4%, III=22.0%). Poorly differentiated tubular adenocarcinomas were more common in group II (I=44.7%, II=59.2%, III=27.3%) (p<0.01). 3) In Borrmann types, type IV was more common in group II (I=7.9%, II=27.8%, III=9.1%) (p<0.01). 4) In tumor location, antral involvement of the tumor was presented in 55.3% of group I, 54.7% of group II, and 67.5% of group III whereas whole involvement of stomach was presented in 5.3% of group I, 15.0% of group II, and 5.2% of group III (p<0.01). 5)Group I had a significantly higher (37.9%) two-year survival rate than the other groups (II=10.9%, III=12.8%) (p<0.01). CONCLUSIONS: This study suggests a greater prognostic benefit for radical surgery in cases of paraaortic lymph-node metastsis than in cases involving other stage IV gastric cancers.
