scholarly journals A Case of Gastric Cancer with Residual Tumor Only in the Para-Aortic Lymph Nodes after Systemic Chemotherapy followed by Conversion Surgery

2015 ◽  
Vol 8 (2) ◽  
pp. 312-322 ◽  
Author(s):  
Masayuki Tsutsuyama ◽  
Seiji Ito ◽  
Yuichi Ito ◽  
Kazunari Misawa ◽  
Jiro Kawakami ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
Systemic Chemotherapy ◽  
Histopathological Examination ◽  
Gastric Wall ◽  
Stage Iv ◽  
Residual Tumor ◽  
Gastric Body ◽  
Upper Gastrointestinal Endoscopy ◽  
Regional Lymph Nodes

We report the case of a 60-year-old male who was diagnosed with gastric cancer. Upper gastrointestinal endoscopy indicated advanced cancer in the posterior wall of the gastric body. Biopsy revealed poorly differentiated adenocarcinoma. Abdominal computed tomography demonstrated thickening of the gastric wall and enlargement of the regional lymph nodes and of the para-aortic lymph nodes (PAN). The involvement of the PAN extended from the celiac axis to the caudal area of the inferior mesenteric artery [cT3N3aH0P0M1(LYM), stage IV]. Systemic chemotherapy was initiated. After 3 courses of S-1 plus cisplatin combination chemotherapy, the primary lesion and the enlarged lymph nodes revealed marked regression except for a minute residual lesion in the lymph nodes. Upon obtaining informed consent, open distal gastrectomy, D2 lymphadenectomy with PAN dissection, and Roux-en-Y reconstruction were performed. The patient was discharged from the hospital 35 days after the operation. Histopathological examination of the resected samples revealed malignant cells only in the PAN, not in the stomach or in the regional lymph nodes [ypT0N0M1(LYM), stage IV]. Currently, the patient is undergoing postoperative adjuvant chemotherapy with S-1 and has remained well without any recurrence after 6 months following surgery.

A case of primary biliary cirrhosis with sarcoid reaction in the regional lymph nodes after surgery of early gastric cancer

Kanzo ◽  
2005 ◽  
Vol 46 (7) ◽  
pp. 437-442 ◽  
Author(s):  
Tadashi YOSHIDA ◽  
Atsushi NAGASAKA ◽  
Yayoi OGAWA ◽  
Syuji NISHIKAWA ◽  
Akifumi HIGUCHI
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Primary Biliary Cirrhosis ◽  
Lymph Nodes ◽  
Biliary Cirrhosis ◽  
Regional Lymph Nodes ◽  
Sarcoid Reaction

BIOPSY OF THE SIGNALING LYMPH NODES IN GASTRIC CANCER - CURRENT STATUS OF THE PROBLEM AND PROSPECTS

2018 ◽  
Vol 64 (3) ◽  
pp. 335-344
Author(s):  
Aleksey Karachun ◽  
Yuriy Pelipas ◽  
Oleg Tkachenko ◽  
D. Asadchaya
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Nodes ◽  
Stomach Cancer ◽  
Current Status ◽  
Regional Lymph Nodes ◽  
Systematic Analysis ◽  
Tumor Spread ◽  
Special Value

The concept of biopsy of sentinel lymph node as the first lymph node in the pathway of lymphogenous tumor spread has been actively discussed over the past decades and has already taken its rightful place in breast and melanoma surgery. The goal of this method is to exclude vain lymphadenectomy in patients without solid tumor metastases in regional lymph nodes. In the era of minimally invasive and organ-saving operations interventions it seems obvious an idea to introduce a biopsy of sentinel lymph node in surgery of early gastric cancer. Meanwhile the complexity of lymphatic system of the stomach and the presence of so-called skip metastases are factors limiting the introduction of a biopsy of sentinel lymph node in stomach cancer. This article presents a systematic analysis of biopsy technology of signaling lymph node as well as its safety and oncological adequacy. Based on literature data it seems to us that the special value of biopsy of sentinel lymph nodes in the future will be in the selection of personalized surgical tactics for stomach cancer.

Multiple early gastric cancer associated with sarcoid-like reaction in the regional lymph nodes

2001 ◽  
Vol 36 (10) ◽  
pp. 710-717 ◽  
Author(s):  
Masayuki Nakamura ◽  
Eishi Mizuta ◽  
Hideshi Morioka ◽  
Mitsuo Nakamura ◽  
Kimio Isiglo
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Lymph Nodes ◽  
Regional Lymph Nodes

scholarly journals Two Cases of Early Gastric Cancer with Sarcoid Reaction in the Regional Lymph Nodes.

1992 ◽  
Vol 25 (10) ◽  
pp. 2520-2524 ◽  
Author(s):  
Hajime Abe ◽  
Nobukuni Terata ◽  
Hisanori Shiomi ◽  
Hiroyuki Naito ◽  
Junsuke Shibata ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Lymph Nodes ◽  
Regional Lymph Nodes ◽  
Sarcoid Reaction

scholarly journals Prognostic significance of regional lymph nodes dissection in gastric cancer.

1986 ◽  
Vol 19 (4) ◽  
pp. 840-843
Author(s):  
Jiro FUJIMOTO ◽  
Isao KOKUNAI ◽  
Tokuhiro MIYAMOTO ◽  
Satoshi TANE ◽  
Hitoshi SHIOZAKI ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
Prognostic Significance ◽  
Regional Lymph Nodes ◽  
Lymph Nodes Dissection

Abstract 1073: Significant association of neutrophils in regional lymph nodes with lymphangiogenesis and micrometastasis by gastric cancer

2014 ◽  
Author(s):  
Mao Tokumoto ◽  
Hiroaki Tanaka ◽  
Masaichi Ohira ◽  
Yukie Go ◽  
Yoshihiro Okita ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
Regional Lymph Nodes

Gastric Cancer with Sarcoid Reactions in the Regional Lymph Nodes, the Stomach Wall, and the Splenic Parenchyma: Report of a Case

Surgery Today ◽  
1999 ◽  
Vol 29 (6) ◽  
pp. 549-552 ◽  
Author(s):  
Hisayuki Shigematsu ◽  
Akira Kurita ◽  
Yasushi Omura ◽  
Yoshiro Kubo ◽  
Shigemitsu Takashima ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
Stomach Wall ◽  
Regional Lymph Nodes ◽  
Splenic Parenchyma

Chemoradiotherapy for highly advanced gastric cancer.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 121-121
Author(s):  
Mai Tsutsui ◽  
Tsunehiro Takahashi ◽  
Yoshiro Saikawa ◽  
Hirofumi Kawakubo ◽  
Norihito Wada ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Radiation Therapy ◽  
Lymph Nodes ◽  
Advanced Gastric Cancer ◽  
Multidisciplinary Treatment ◽  
Multimodality Treatment ◽  
Complete Response ◽  
Technological Advancement ◽  
Regional Lymph Nodes ◽  
Grade 3

121 Background: Although the prognosis of early gastric cancer is favorable, the treatment for advanced cases still have difficulty in achieving satisfactory results. Thus, more effective multimodality treatment should be established. Chemoradiotherapy has become a standard treatment for gastric cancer especially as an adjuvant therapy while radiotherapy has been expected as one of the modalities against highly advanced gastric cancer. Methods: Patients with advanced gastric cancer who were treated with chemotherapy of S-1 and cisplatin plus radiation were analyzed retrospectively. Concurrent radiation therapy (5 days/week) at 2 Gy/day was started with chemotherapy and repeated daily on days 1–5, 8–12, 15–19 and 22–26. Irradiation was planned using a computed tomography (CT) simulator for two rectangular portals with a pair of 45-degree wedge filters and was targeted at the primary tumor and surrounding lesions, including lymph nodes. Results: A total 109 patients were treated with chemoradiotherapy between 2002 and 2013 at our institute. The median age was 64 years. Histological type included 45 differentiated and undifferentiated 64 subtypes. The TNM stage before the treatment was diagnosed as IIIA: 11; IIIB: 10; IIIC: 14; IV: 74. Of the 98 evaluable patients, 69 patients had partial responses while no patients had a complete response, resulting in an overall response rate of 70%. Progressive disease (PD) occurred in 2 patients (4%). The most frequent adverse events more than grade 3 were hematologic toxicities, including leukocytopenia (47%), neutropenia (25%), and thrombocytopenia (24%). Non-hematologic toxicities such as general fatigue, renal-related events, and gastrointestinal toxicities were manageable with no treatment-related death. The median survival time was 537 days. Conclusions: While there were disadvantages of radiotherapy including the difficulty of confirming the area of irradiation due to peristaltic movement, risk of perforation and ulceration, recent technological advancement of radiation therapy has enabled pinpoint accuracy in treatment of primary gastric lesions and regional lymph nodes. There has been much anticipation that chemoradiotherapy will be a part of multidisciplinary treatment for advanced cancer.

The prognostic factor and the optimal timing of conversion surgery in unresectable stage IV gastric cancer: A retrospective analysis.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 78-78
Author(s):  
Tamotsu Sagawa ◽  
Yutaka Okagawa ◽  
Fumito Tamura ◽  
Tsuyoshi Hayashi ◽  
Koshi Fujikawa ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Survival Rate ◽  
Univariate Analysis ◽  
Stage Iv ◽  
Residual Tumor ◽  
Optimal Timing ◽  
Conversion Surgery ◽  
Stage Iv Gastric Cancer ◽  
Metastatic Lesions ◽  
Unresectable Stage

78 Background: Conversion surgery could be an option for unresectable stage IV gastric cancer when distant metastasis (M1) is disappeared by chemotherapy. However, the indication and the optimal timing of conversion surgery in stage IV gastric cancer remain unclear, even if metastatic lesions disappear with chemotherapy. Guideline of National Comprehensive Cancer Network also shows no principle after down-staging. Methods: This retrospective study examined 34 gastric cancer patients who underwent curative conversion surgery at our institute between 2005 and 2014. Clinicopathologic characteristics and patient outcomes were analyzed, with particular focus on the potential to select patients who might benefit from surgical resection. Results: The number of M1 factors was one in 31 patients and two in 3, including metastases to non-regional lymph node in 21, peritoneum in 8, liver in 5, and lung in 3. The regimen of chemotherapy was Docetaxel/CDDP/S-1 in 23 patients, Docetaxel/CDDP/S-1+Trastuzmab in 6, S-1/CDDP in 2, Docetaxel/S-1 in 1, CPT/CDDP in 1, and S-1 monotherapy in 1. The median duration from initiation of chemotherapy to the operation was 114 days (range 37-653 days). Total gastrectomy was performed in 27 patients and distal gastrectomy was performed in 7 patients. Complete resection with no residual tumor (R0) was achieved in 23 of 34 patients, microscopic residual tumor status (R1) in 10, and macroscopic residual tumor (R2) in 1. The 3-year overall survival (OS) rate among the patients who underwent conversion therapy was 58.0% with MST of 1190 days. Univariate analysis among the patents with conversion surgery identified intestinal differentiation, pathological response grade≧1b, R0 resection as significant prognostic factors. Patients operated on more than 91 days from initiation of chemotherapy had the 3-year survival rate of 68.2%, compared to 40.0% for patients operated on less than 90 days. Conclusions: Our data demonstrate the increased 3-year survival rate associated with delayed conversion surgery for stage IV gastric cancer. Delayed conversion surgery should be considered for patients, even if metastatic lesions disappear with chemotherapy.

Sign in / Sign up

Export Citation Format

Share Document