Korean J Clin Oncol.  2019 Dec;15(2):100-105. 10.14216/kjco.19018.

Risk factors for atypical lymph node metastasis in gastric cancer

• Jung J
• Yoon SI
• Lee KH
• Won Y
• Min SH
• Park YS
• Ahn SH
• Park DJ
• Kim HH

• KMID: 2470673
• DOI: http://doi.org/10.14216/kjco.19018

Abstract

PURPOSE
The present study aimed to evaluate atypical lymph node metastasis rates according to tumor depth, size, and location in patients with gastric cancer.
METHODS
A total of 727 gastric adenocarcinoma patients, with metastasis to 1 or 2 lymph nodes, who underwent radical gastrectomy with curative intent from May 2003 to May 2017, were enrolled in this study. The characteristics of atypical (skip or transversal) metastases were evaluated according to the following risk factors: longitudinal versus circumferential location, size, and T stage of the tumor.
RESULTS
The rates of skip and transversal metastases were 8.4% and 15.5%, respectively. Skip metastases were present throughout, regardless of the primary tumor location. On the contrary, transversal metastases of gastric cancer were most frequently observed in the lower third region (19.5%, P=0.002). When the size of the tumor is large (>4 cm), transversal metastasis was found to be significantly more common (P=0.035), compared with skip metastasis, which was less common (P=0.011). There was no significant correlation between atypical metastases and tumor depth.
CONCLUSION
Lower and larger tumors were more likely to have transversal metastases compared with others; however, skip metastases were less common in large tumors.

Keyword

Stomach neoplasms; Lymph node dissection

MeSH Terms

Adenocarcinoma
Gastrectomy
Humans
Lymph Node Excision
Lymph Nodes*
Neoplasm Metastasis*
Risk Factors*
Stomach Neoplasms*