Yonsei Med J.  1992 Jun;33(2):143-152. 10.3349/ymj.1992.33.2.143.

Should all the N3 lymph nodes group metastasis be regarded as distant metastasis (M1) in curatively resected gastric cancer

• Chung HC
• Lim HY
• Koh EH
• Kim JH
• Roh JK
• Park IS
• Min JS
• Lee KS
• Youn JK
• Kim BS
• Lee KB

• KMID: 1964886
• DOI: http://doi.org/10.3349/ymj.1992.33.2.143

Abstract

Recently, metastasis to N3 lymph nodes group was regarded as distant metastasis by the new TNM staging system due to poor overall survival. However, the 5-year overall survival rate of patients with metastasis to N3 groups was 34.5% after curative surgery. Moreover, in patients with metastasis to lymph node subgroups of #12, #13, #14, the overall 5-year survival rate increased upto 47.2% after curative resection and adjuvant chemotherapy. This was similar to that of the patients with metastasis to N1 and N2 lymph nodes groups. But in these highly tumor burden states, no survival benefit was found with the addition of immunotherapy to chemotherapy as we achieved in stage II and III. Therefore, we suggest that, at least, metastasis to #12, #13, #14 lymph nodes subgroups should not be categorized as a distant metastasis. And in these situations, active curative radical surgery with extended lymphadenectomy and adjuvant chemotherapy are recommended.

Keyword

N3; distant metastasis; extended lymphaednectomy

MeSH Terms

Adult
Chemotherapy, Adjuvant
Female
Human
Lymphatic Metastasis
Male
Middle Age
Stomach Neoplasms/mortality/*pathology/surgery
Survival Rate