Surgical treatment and outcome for node-negative gastric cancer

Maehara, Yoshihiko; Tomoda, Masashi; Tomisaki, Shinichi; Ohmori, Mariko; Baba, Hideo; Akazawa, Kohei; Sugimachi, Keizō

doi:10.1016/s0039-6060(97)90051-9

Cited by 39 publications

(46 citation statements)

References 31 publications

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“…The pathohistological findings in our study do not differ from those of larger series in regard to depth of infiltration, incidence of lymph node involvement, or histological grading [28][29][30][31]. The distribution in localization is similar to the Japanese series and somewhat different from Western university institutions in which a markedly higher proportion of proximal cancers is present [3][4][5]9,20,21,23,24]. The fact that lymph node invasion increases drastically with tumor penetration to the submucosa may be explained by the wide network of lymph capillaries found in the submucosa [43][44][45].…”

Section: Discussionsupporting

confidence: 53%

“…According to the Japanese criteria for minimally invasive treatment, only 11 cases of our EGC series would have been suitable for possible endoscopic resection. With exception of subtypes of EGC, radical surgery with D2 lymph node dissection, as employed in Japan since the 1950s [3][4][5][6][7][8][18][19][20][21][22][23][24], is of decisive importance for patient outcome. Japanese [3][4][5][6][7][8][18][19][20][21][22][23][24] and European and American studies [27][28][29][30][31]46] as well have demonstrated the worth of lymphadenectomy, not only for EGC.…”

Section: Discussionmentioning

confidence: 99%

“…This characterization resulted in the introduction of endoscopical therapy modalities for these EGC types of low malignancy, which has been confirmed by long-term results [13,[15][16][17]. For all other EGC, radical lymph node dissection according to the JRSGC was suggested by Japanese institutions [18][19][20][21][22][23][24].…”

Section: Introductionmentioning

confidence: 97%

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Long-term results of early gastric cancer accomplished in a European institution by Japanese-type radical resection

et al. 1999

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

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Long-term results of early gastric cancer accomplished in a European institution by Japanese-type radical resection

et al. 1999

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“…This surgical strategy was also employed for patients with advanced gastric cancer. We previously reported that prophylactic lymph node dissection promoted increased survival time in patients with advanced gastric cancer [23,24].…”

Section: Discussionmentioning

confidence: 99%

Clinical significance of micrometastasis in bone marrow of patients with gastric cancer and its relation to angiogenesis

et al. 1999

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Abstract:Background. Detection of micrometastasis is an important problem of clinical significance for a better understanding and control of tumor progression, which will improve patients' survival time.Methods. To identify micrometastases in bone marrow, an immunocytochemical assay for epithelial cytokeratin protein was performed in 106 patients with primary gastric cancer. Also, in 40 of the 106 patients, vascular endothelial growth factor (VEGF) expression and intratumoral vessel density were examined by an immunohistochemical staining method. Results. Of the 106 patients, 22 (20.8%) presented with cytokeratin-positive cells in bone marrow at the time of primary surgery. The positive findings were related to depth of invasion, peritoneal dissemination, and liver metastasis. Patients with cytokeratin-positivity in bone marrow had a higher VEGF positive rate (73%; 8/11) than did cytokeratin-negative patients (48%; 14/29). Intratumoral vessel density in VEGFpositive patients was 26.9 ؎ 10.3, which was significantly higher than that in VEGF-negative patients (13.2 ؎ 8.7, P < 0.05). Thus, the presence of cytokeratin-positive cells in bone marrow was closely related to angiogenesis in the primary tumor. Conclusions. Cytokeratin staining can be useful for identifying patients at high risk for metastasis. Prophylactic lymph node dissection, adjuvant chemotherapy, and antiangiogenic treatment may be necessary for patients with micrometastasis.

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“…Although several investigators reported that the postoperative prognosis of lymph node-negative gastric cancer patients was significantly better than that of lymph node-positive gastric cancer patients, some researchers found that a minority of lymph node-negative gastric cancer patients had recurrence and poor survival (21)(22)(23)(24)(25). Identification of the factors associated with survival and recurrence of lymph node-negative gastric cancer patients following curative resection is important for choosing the appropriate recipients of sequentially essential adjuvant therapy.…”

Section: Discussionmentioning

confidence: 99%

Prognosis of Gastric Cancer Patients with Node-Negative Metastasis following Curative Resection: Outcomes of the Survival and Recurrence

Deng

Liang

Sun

et al. 2008

Canadian Journal of Gastroenterology

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of gastric cancer patients with node-negative metastasis following curative resection: Outcomes of the survival and recurrence. Can J Gastroenterol 2008;22(10):835-839.BACKGROUND: The purpose of the present study was to provide valuable prognostic information on lymph node-negative gastric cancer patients following curative resection. METHODS: Data from 112 lymph node-negative gastric cancer patients who underwent curative resection were reviewed to identify the independent factors of overall survival and recurrence. RESULTS: The five-year survival rate of lymph node-negative gastric cancer patients was 85.7%, and recurrence was identified in 25 patients after curative surgery. The five-year survival rate of lymph node-negative gastric cancer patients was higher than that of lymph node-positive gastric cancer patients (P<0.001). Recurrence in lymph node-negative gastric cancer patients was less than that of lymph node-positive gastric cancer patients (P=0.001). The median survival after recurrence of lymph node-negative gastric cancer patients was longer than that of lymph node-positive gastric cancer patients (P=0.021). Using multivariate analyses, the following results were determined for lymph node-negative gastric cancer patients: sex, operative type and the presence of serosal involvement were independent factors of overall survival; and lymphadenectomy, number of dissected nodes and the presence of serosal involvement were independent factors of recurrence. CONCLUSIONS: The prognosis of lymph node-negative gastric cancer patients was better than that of lymph node-positive gastric cancer patients. Male sex, subtotal gastrectomy and nonserosal involvement should be considered to be the favourable predictors of postoperative long-term survival of lymph node-negative gastric cancer patients. Conversely, limited lymphadenectomy, few dissected nodes and serosal involvement should be considered to be risk factors of postoperative recurrence of lymph node-negative gastric cancer patients.

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Surgical treatment and outcome for node-negative gastric cancer

Cited by 39 publications

References 31 publications

Long-term results of early gastric cancer accomplished in a European institution by Japanese-type radical resection

Long-term results of early gastric cancer accomplished in a European institution by Japanese-type radical resection

Clinical significance of micrometastasis in bone marrow of patients with gastric cancer and its relation to angiogenesis

Prognosis of Gastric Cancer Patients with Node-Negative Metastasis following Curative Resection: Outcomes of the Survival and Recurrence

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