Neoadjuvant chemotherapy with S-1 and cisplatin followed by D2 gastrectomy with para-aortic lymph node dissection for gastric cancer with extensive lymph node metastasis

2014 ◽  
Vol 101 (6) ◽  
pp. 653-660 ◽  
Author(s):  
A. Tsuburaya ◽  
J. Mizusawa ◽  
Y. Tanaka ◽  
N. Fukushima ◽  
A. Nashimoto ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Neoadjuvant Chemotherapy ◽  
Lymph Node Dissection ◽  
Node Dissection ◽  
D2 Gastrectomy ◽  
Node Metastasis ◽  
Aortic Lymph Node ◽  
Extensive Lymph Node

Prognostic Factors for Para-aortic Lymph Node Dissection After Neoadjuvant Chemotherapy for Gastric Cancer

2020 ◽  
Vol 40 (4) ◽  
pp. 2351-2357
Author(s):  
SHUNJI ENDO ◽  
MASAKAZU IKENAGA ◽  
TERUMASA YAMADA ◽  
SHIGEYUKI TAMURA ◽  
YO SASAKI
Keyword(s):  
Gastric Cancer ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Neoadjuvant Chemotherapy ◽  
Lymph Node Dissection ◽  
Node Dissection ◽  
Aortic Lymph Node

scholarly journals Role of D2 gastrectomy in gastric cancer with clinical para-aortic lymph node metastasis

2019 ◽  
Vol 25 (19) ◽  
pp. 2338-2353 ◽  
Author(s):  
Xiao-Hao Zheng ◽  
Wen Zhang ◽  
Lin Yang ◽  
Chun-Xia Du ◽  
Ning Li ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
D2 Gastrectomy ◽  
Node Metastasis ◽  
Aortic Lymph Node

scholarly journals Significance of Lymph Node Metastasis in the Treatment of Gastric Cancer and Current Challenges in Determining the Extent of Metastasis

2022 ◽  
Vol 11 ◽  
Author(s):  
Shinichi Kinami ◽  
Hitoshi Saito ◽  
Hiroyuki Takamura
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Sentinel Node ◽  
Sentinel Node Biopsy ◽  
Lymph Node Dissection ◽  
Node Dissection ◽  
Node Metastasis ◽  
Node Biopsy

The stomach exhibits abundant lymphatic flow, and metastasis to lymph nodes is common. In the case of gastric cancer, there is a regularity to the spread of lymph node metastasis, and it does not easily metastasize outside the regional nodes. Furthermore, when its extent is limited, nodal metastasis of gastric cancer can be cured by appropriate lymph node dissection. Therefore, identifying and determining the extent of lymph node metastasis is important for ensuring accurate diagnosis and appropriate surgical treatment in patients with gastric cancer. However, precise detection of lymph node metastasis remains difficult. Most nodal metastases in gastric cancer are microscopic metastases, which often occur in small-sized lymph nodes, and are thus difficult to diagnose both preoperatively and intraoperatively. Preoperative nodal diagnoses are mainly made using computed tomography, although the specificity of this method is low because it is mainly based on the size of the lymph node. Furthermore, peripheral nodal metastases cannot be palpated intraoperatively, nodal harvesting of resected specimens remains difficult, and the number of lymph nodes detected vary greatly depending on the skill of the technician. Based on these findings, gastrectomy with prophylactic lymph node dissection is considered the standard surgical procedure for gastric cancer. In contrast, several groups have examined the value of sentinel node biopsy for accurately evaluating nodal metastasis in patients with early gastric cancer, reporting high sensitivity and accuracy. Sentinel node biopsy is also important for individualizing and optimizing the extent of uniform prophylactic lymph node dissection and determining whether patients are indicated for function-preserving curative gastrectomy, which is superior in preventing post-gastrectomy symptoms and maintaining dietary habits. Notably, advancements in surgical treatment for early gastric cancer are expected to result in individualized surgical strategies with sentinel node biopsy. Chemotherapy for advanced gastric cancer has also progressed, and conversion gastrectomy can now be performed after downstaging, even in cases previously regarded as inoperable. In this review, we discuss the importance of determining lymph node metastasis in the treatment of gastric cancer, the associated difficulties, and the need to investigate strategies that can improve the diagnosis of lymph node metastasis.

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