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Metastatic patterns and surgical methods for lymph nodes No. 5 and No. 6 in proximal gastric cancer

OBJECTIVE: The current surgical treatment guidelines for early proximal gastric cancer (PGC) still lack agreement. Lymphadenectomy of lymph nodes No. 5 and No. 6 is the major difference between total and proximal gastrectomy. We elucidated the appropriate surgical procedure for PGC by investigating...

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Autores principales: Wang, Jinou, Wu, Pei, Wang, Zhenning, Li, Kai, Huang, Baojun, Wang, Pengliang, Xu, Huimian, Zhu, Zhi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6433591/
https://www.ncbi.nlm.nih.gov/pubmed/30996575
http://dx.doi.org/10.21147/j.issn.1000-9604.2019.01.12
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author Wang, Jinou
Wu, Pei
Wang, Zhenning
Li, Kai
Huang, Baojun
Wang, Pengliang
Xu, Huimian
Zhu, Zhi
author_facet Wang, Jinou
Wu, Pei
Wang, Zhenning
Li, Kai
Huang, Baojun
Wang, Pengliang
Xu, Huimian
Zhu, Zhi
author_sort Wang, Jinou
collection PubMed
description OBJECTIVE: The current surgical treatment guidelines for early proximal gastric cancer (PGC) still lack agreement. Lymphadenectomy of lymph nodes No. 5 and No. 6 is the major difference between total and proximal gastrectomy. We elucidated the appropriate surgical procedure for PGC by investigating the pathological characteristics and prognostic significance of lymph nodes No. 5 and No. 6. METHODS: In total, 333 PGC patients who underwent total gastrectomy were enrolled in this study. We investigated their clinicopathological characteristics and the metastatic patterns of the lymph nodes. Patients with metastasis in lymph nodes No. 5 and No. 6 were combined into one group and we compared the difference in survival between those with and without metastasis in lymph nodes No. 5, 6 (lymph nodes No. 5 and No. 6 in any group of metastasis) for different subgroups. RESULTS: The metastatic rates for lymph nodes No. 5 and No. 6 in PGC were 9.91% and 16.11%, respectively. The metastatic rate for both lymph nodes No. 5, 6 was 20.42%. Multivariate analysis showed that positive metastasis in lymph node No. 4, depth of invasion, and tumor size were independently correlated with the presence of metastasis in lymph nodes No. 5, 6. CONCLUSIONS: When lymph node No. 4 is positive (intraoperative pathology) or tumor size ≥5 cm or T4 stage, lymphadenectomy should be performed for lymph nodes No. 5 and No. 6, and total gastrectomy is recommended.
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spelling pubmed-64335912019-04-17 Metastatic patterns and surgical methods for lymph nodes No. 5 and No. 6 in proximal gastric cancer Wang, Jinou Wu, Pei Wang, Zhenning Li, Kai Huang, Baojun Wang, Pengliang Xu, Huimian Zhu, Zhi Chin J Cancer Res Original Article OBJECTIVE: The current surgical treatment guidelines for early proximal gastric cancer (PGC) still lack agreement. Lymphadenectomy of lymph nodes No. 5 and No. 6 is the major difference between total and proximal gastrectomy. We elucidated the appropriate surgical procedure for PGC by investigating the pathological characteristics and prognostic significance of lymph nodes No. 5 and No. 6. METHODS: In total, 333 PGC patients who underwent total gastrectomy were enrolled in this study. We investigated their clinicopathological characteristics and the metastatic patterns of the lymph nodes. Patients with metastasis in lymph nodes No. 5 and No. 6 were combined into one group and we compared the difference in survival between those with and without metastasis in lymph nodes No. 5, 6 (lymph nodes No. 5 and No. 6 in any group of metastasis) for different subgroups. RESULTS: The metastatic rates for lymph nodes No. 5 and No. 6 in PGC were 9.91% and 16.11%, respectively. The metastatic rate for both lymph nodes No. 5, 6 was 20.42%. Multivariate analysis showed that positive metastasis in lymph node No. 4, depth of invasion, and tumor size were independently correlated with the presence of metastasis in lymph nodes No. 5, 6. CONCLUSIONS: When lymph node No. 4 is positive (intraoperative pathology) or tumor size ≥5 cm or T4 stage, lymphadenectomy should be performed for lymph nodes No. 5 and No. 6, and total gastrectomy is recommended. AME Publishing Company 2019-02 /pmc/articles/PMC6433591/ /pubmed/30996575 http://dx.doi.org/10.21147/j.issn.1000-9604.2019.01.12 Text en Copyright © 2019 Chinese Journal of Cancer Research. All rights reserved. http://creativecommons.org/licenses/by-nc-sa/4.0/ This work is licensed under a Creative Commons Attribution-Non Commercial-Share Alike 4.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/
spellingShingle Original Article
Wang, Jinou
Wu, Pei
Wang, Zhenning
Li, Kai
Huang, Baojun
Wang, Pengliang
Xu, Huimian
Zhu, Zhi
Metastatic patterns and surgical methods for lymph nodes No. 5 and No. 6 in proximal gastric cancer
title Metastatic patterns and surgical methods for lymph nodes No. 5 and No. 6 in proximal gastric cancer
title_full Metastatic patterns and surgical methods for lymph nodes No. 5 and No. 6 in proximal gastric cancer
title_fullStr Metastatic patterns and surgical methods for lymph nodes No. 5 and No. 6 in proximal gastric cancer
title_full_unstemmed Metastatic patterns and surgical methods for lymph nodes No. 5 and No. 6 in proximal gastric cancer
title_short Metastatic patterns and surgical methods for lymph nodes No. 5 and No. 6 in proximal gastric cancer
title_sort metastatic patterns and surgical methods for lymph nodes no. 5 and no. 6 in proximal gastric cancer
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6433591/
https://www.ncbi.nlm.nih.gov/pubmed/30996575
http://dx.doi.org/10.21147/j.issn.1000-9604.2019.01.12
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