Type‐oriented therapy for gastric cancer effective for lymph node metastasis: Management of lymph node metastasis using activated carbon particles adsorbing an anticancer agent

Abstract

Activated carbon particles are taken selectively up by lymphatics when injected into the tissues and visualize regional lymph nodes colored black. Furthermore, carbon particles adsorb a large amount of the anticancer agent mitomycin C (MMC) on their surface and release the drug reversibly. Using these properties of activated carbon particles, we have applied it for lymph node dissection and chemotherapy of lymph node metastasis. After injection of carbon particles, regional lymph nodes of the stomach were found to be black; blackened lymph nodes extending widely from perigastric to para-aortic nodes were identified from other structures. Four hundred and twenty-four patients with gastric cancer were treated with this method for lymph node metastasis during 1984-1988. Involved nodes were generally colored in high incidence, about 70% of involved ones except for highly positive nodes, which was the same as noninvolved nodes. In highly positive nodes, the colored incidence was decreased to about 48%. The cumulative 5-year survival rate of the patients treated with this series was 74.6%, which was significantly higher than the figures without this method.

Survival benefits from splenic hilar lymph node dissection by splenectomy in gastric cancer patients: relative comparison of the benefits in subgroups of patients

“…Lymphatic flow around the stomach was well investigated by Takahashi et al using activated carbon particles, which flow through the lymphatic vessels [19]. They reported that activated carbon particles injected into the wall of the upper portion of the greater curvature of the stomach flowed to the splenic hilar nodes.…”

Total gastrectomy with simultaneous pancreaticosplenectomy or splenectomy in patients with advanced gastric carcinoma

“…Lymphatic flow around the upper portion of the greater curvature of the stomach has been reported, toward the nodes around the splenic hilus and splenic artery (Takahashi et al, 1991). Yoshino et al have reported that spread of carcinoma is often to the lymph nodes around the splenic hilus and splenic artery when the primary tumour is located along the greater curvature of the upper third of the stomach (Yoshino et al, 1979).…”

Lymph Node Involvement in Gastric Cancer for Different Tumor Sites and T Stage

“…Anatomy [10,25,27,33] and physiology [9,28,32,36] studies conducted on the gastric lymphatic drainage identified different pathways depending on the stomach's regions. Upper third lymphatic vessels run along left gastric artery, posterior gastric artery, and splenic artery, whereas the lower third has lymphatic vessels accompanying common hepatic artery and superior mesenteric artery.…”