Clinical characteristics of gastric cancer with metastasis to the lymph node along the superior mesenteric vein (14v)

Taka Aki Masuda, Yoshihisa Sakaguchi, Yasushi Toh, Yoshiro Aoki, Norifumi Harimoto, Junya Taomoto, Osamu Ikeda, Takefumi Ohga, Eisuke Adachi, Takeshi Okamura

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Abstract

Aim: We investigated the clinical significance of metastasis to the lymph node (LN) along the superior mesenteric vein (14v) in gastric cancer. Methods: A retrospective study of 2,513 gastrectomy patients with a 14v dissection was done using the Ganken Igan Database. Results: The incidence of 14v metastasis correlated with tumor location, depth of tumor invasion, regional LN metastases, peritoneal metastasis, peritoneal cytology-positive, hepatic metastasis and postoperative recurrence (p < 0.01). Metastases to the infrapyloric LN (6), suprapyloric LN (5) and left paracardial LN (2) were independent variables affecting 14v metastasis (p < 0.05), and the 6 status was a useful predictive factor for a 14v-negative status with a low false-negative rate (1.9%). The patients with 14v metastasis after curative surgery demonstrated a significantly lower survival rate than those without (5-year overall survival rate; 11.3 vs. 60.2%, p < 0.0001). In them, LN around the abdominal aorta (16)-positive group showed a significantly lower survival rate than the negative group (p < 0.05). Conclusions: Advanced gastric cancer with invasion to the lower stomach often metastasizes to 14v, and the 6 status can predict 14v negative. Most patients with 14v metastasis have a poor prognosis, similar to those with systemic metastasis, although some such patients may benefit from a curative dissection.

Original languageEnglish
Pages (from-to)351-358
Number of pages8
JournalDigestive surgery
Volume25
Issue number5
DOIs
Publication statusPublished - Dec 1 2008

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All Science Journal Classification (ASJC) codes

  • Surgery
  • Gastroenterology

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