Lymph node metastases rate of locoregional and non-locoregional lymph node stations in gastric cancer

Jong, M. H. S. de; Gisbertz, Suzanne S.; Henegouwen, Mark I. van Berge; Draaisma, Werner A.

doi:10.21037/jgo-22-147

Cited by 4 publications

(3 citation statements)

References 33 publications

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“…In current literature, abdominal lymph node may be dissected in advanced esophagogastric junction adenocarcinoma; however, it’s under argument because of different histologies ( 10 ). To RPLN metastases of patients with advanced gastric cancer, D2 lymphadenectomy may be sufficient but accompanied with higher morbidity and mortality ( 11 - 13 ). So the extent of lymphadenectomy is still disputed.…”

Section: Introductionmentioning

confidence: 99%

PD-1 inhibition combined with intensity-modulated radiotherapy, to better serve patients with retroperitoneal lymph node metastases from gastrointestinal cancer

Lu,

Fang,

Tao

et al. 2024

J Gastrointest Oncol

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Background Gastrointestinal (GI) cancer is the most frequent kind of cancer to involve the retroperitoneal lymph nodes (RPLNs). Radiotherapy (RT) is common treatment of RPLN metastases in patients with GI cancer, while RT is local. Meanwhile, most patients have extra-retroperitoneal metastases. Immunotherapy plus RT have showed effective in advanced non-small cell lung cancer. However, whether the combination therapy is effective on GI cancer with RPLN metastases. In our study, we would estimate the effect of programmed death-1 (PD-1) inhibition in association with intensity modulated radiation therapy (IMRT). Methods Metastatic GI cancer patients with RPLN who were treated at a single institution were retrospectively evaluated from October 2016 to April 2023, who all had measurable lesion and received any therapy of PD-1 inhibitors alone, IMRT alone or PD-1 inhibitors plus IMRT. The follow-ups were assessed by abdominal computed tomography (CT) every 2 or 3 months to progression, dose-limiting toxicity or death. Results Among the 98 patients, 46 were treated by PD-1 inhibitors combined with IMRT, 26 were by PD-1 inhibitors only and 26 were by IMRT only. Of those, the median age 62 years (range, 25–84 years). Median progression-free survival (PFS) was 7.5 months and median overall survival (OS) was 10.8 months across the 3 therapy groups. Univariate analysis (UVA) indicated that therapy method (P=0.032) and tumor response (P=0.035) were significantly related to PFS. In the PD-1 inhibitors plus IMRT group, 1 patient (2.2%) achieved complete response (CR), 30 (65.2%) had partial remission, and 14 (30.4%) had stable disease. There was no case with CR by IMRT or PD-1 inhibitors alone. Objective response rate (67.4%) and disease control rate (97.8%) were higher in the PD-1 inhibitors combined with IMRT group. In the PD-1 inhibitors plus IMRT and PD-1 inhibitors alone groups, hepatitis B virus (HBV)-positive patients had better OS (P=0.041) on UVA. Meanwhile, in the PD-1 inhibitors plus IMRT group, we observed superior PFS (P=0.041) and OS (P=0.049) in HBV-positive patients on UVA. Conclusions PD-1 inhibitors plus IMRT may be a better method for advanced GI cancer patients with RPLN metastases. HBV-positive patients can benefit from either PD-1 inhibitors alone or in combination with IMRT.

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Section: Introductionmentioning

confidence: 99%

PD-1 inhibition combined with intensity-modulated radiotherapy, to better serve patients with retroperitoneal lymph node metastases from gastrointestinal cancer

Lu,

Fang,

Tao

et al. 2024

J Gastrointest Oncol

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“…The presence of lymph node (LN) metastasis is one of the most significant prognostic factors in patients with gastric cancer (GC) [ 1 , 2 , 3 ]. Metastases occur during the early stages of the disease [ 3 , 4 , 5 , 6 ], and because their pre- and intra-operative diagnosis remain unreliable, a D2 lymphadenectomy should be performed whenever nodal involvement is suspected [ 6 , 7 , 8 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…The classification of LN metastasis in patients with gastric cancer is controversial [9][10][11][12][13][14][15][16]. The numerical criterion has been introduced in place of the anatomical one, defining a minimum of 16 LNs retrieved as an adequate number in standard gastrectomy to ensure reliable N staging [17,18].…”

Section: Introductionmentioning

confidence: 99%

Pattern of Distribution of Lymph Node Metastases in Individual Stations in Middle and Lower Gastric Carcinoma

Brisinda

Chiarello²,

Fico

et al. 2023

Cancers

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(1) Background: Lymph node (LN) dissection is the cornerstone of curative treatment of GC. The pattern of distribution of LN metastases is closely related to several factors. The aim of this study is to evaluate the factors determining the distribution of nodal metastases in a population of N+ distal GC patients undergoing gastrectomy and D2 lymphadenectomy. (2) Methods: The medical charts of 162 N+ GC patients who underwent surgical resection over a 15-year period were retrospectively analyzed. Clinical, pathological and anatomical characteristics were evaluated to identify the factors affecting the patterns and prevalence of metastases in individual LN stations. (3) Results: LN metastasis is correlated with the depth of the tumor and to diffuse-type tumors. A higher number of metastatic nodes was documented in patients with middle-third tumors (8.2 ± 7.3 vs. 4.5 ± 5.0 in lower-third tumors, p = 0.0001) and in patients with tumors located on the lesser curve. Station 4 showed the highest rate of metastases (53.1%). Concerning stations 7 to 12, station 8 showed the highest metastasis rate (28.4%). Metastases at stations 1, 2, 4 and 7 to 11 were dominant in middle-third cancer, whereas stations 5 and 6 were dominant in lower-third cancers. Station 4, 5, 6, 10 and 11 metastases were dominant when the cancer was located on the greater curve, whereas stations 1, 2, 7, 8 and 12 were dominant in lesser-curve cancers. (4) Conclusions: The study documented that in patients with distal GC, the distribution of nodal metastases at individual stations is closely related to primary tumor location.

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Current standards of lymphadenectomy in gastric cancer

Fico,

Tropeano,

Brisinda

2023

Updates Surg

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Lymph node metastases rate of locoregional and non-locoregional lymph node stations in gastric cancer

Cited by 4 publications

References 33 publications

PD-1 inhibition combined with intensity-modulated radiotherapy, to better serve patients with retroperitoneal lymph node metastases from gastrointestinal cancer

PD-1 inhibition combined with intensity-modulated radiotherapy, to better serve patients with retroperitoneal lymph node metastases from gastrointestinal cancer

Pattern of Distribution of Lymph Node Metastases in Individual Stations in Middle and Lower Gastric Carcinoma

Current standards of lymphadenectomy in gastric cancer

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