Scope definition and resection significance of No. 12a group lymph nodes in gastric cancer

Huang,Yongjian; Zhu,Guangwei; Zheng,Wei; Hua,Jin; Yang,Shugang; Zhuang,Jinfu; Wang,Jinzhou; Ye,Jianxin

doi:10.3892/mco.2016.911

August-2016 Volume 5 Issue 2

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August-2016 Volume 5 Issue 2

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Article Open Access

Scope definition and resection significance of No. 12a group lymph nodes in gastric cancer

Authors:
- Yongjian Huang
- Guangwei Zhu
- Wei Zheng
- Jin Hua
- Shugang Yang
- Jinfu Zhuang
- Jinzhou Wang
- Jianxin Ye
View Affiliations / Copyright

Affiliations: Department of Gastrointestinal Surgery 2 Section, The First Hospital Affiliated to Fujian Medical University, Fuzhou, Fujian 350004, P.R. China

Copyright: © Huang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
Pages: 257-262
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Published online on: May 24, 2016

https://doi.org/10.3892/mco.2016.911
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Abstract

A discrepancy exists between the 7th edition guidelines of the American Joint Committee on Cancer (AJCC) and the 3rd edition Japanese treatment guidelines in terms of the classification of No. 12a lymph nodes as regional or distant lymph nodes in D2 lymphadenectomy for gastric cancer. The scope definition of No. 12a lymph nodes has yet to be fully elucidated. The present study aimed to assess the appropriateness of reclassifying No. 12a lymph node metastasis as distant metastasis according to the survival rate outcome, and to provide a clear and practical definition of the No. 12a group lymph nodes of gastric cancer. A retrospective analysis was performed on patients with gastric cancer who underwent standard or greater lymphadenectomy between January 2000 and December 2009 to find an association between No. 12a node metastasis and survival outcome. The present study first presented a clear and practical scope definition of the No. 12a group lymph nodes of gastric cancer, according to our clinical experiences and practices (Table I and Fig. 1). The survival outcome of patients with gastric cancer and No. 12a lymph node metastasis was poorer compared with that of patients with no No. 12a lymph node metastasis (P=0.0003). The results were similar in stage III patients with gastric cancer (P<0.0001). However, the survival outcome of patients was similar with or without No. 12a lymph node metastasis in stage IV gastric cancer (P=0.1968). Cox regression analysis revealed that the AJCC stage was independently associated with an unfavorable cumulative survival rate. Logistic regression analysis revealed that tumor location, AJCC stage, intravascular cancer emboli and nerve invasion were associated with No. 12a lymph node metastasis. In conclusion, the data in the present study suggested that No. 12a lymph node metastasis is associated with distant metastasis, and therefore they concur with the 7th edition AJCC gastric cancer guidelines, which appear to be correct in terms of considering No. 12a lymph node metastasis as distant metastasis.

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1	Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D and Bray F: GLOBOCAN 2012v1.0. Cancer incidence and mortality worldwide: IARC CancerBase (no. 11. Lyon). 2013.http://globocan.iarc.frAccessed. April 25–2014
2	Carneiro F: Stomach Cancer. Steward B and Wild CP: WorldCancer Report, IARC. Lyon: 383–391. 2014.
3	Aurello P, D'Angelo F, Nigri G, Bellagamba R, Cicchini C, Ruzzetti R and Ramacciato G: Comparison between site N-category and number N-category for nodal staging in carcinoma of the gastroesophageal junction: Our experience and literature review. Am Surg. 72:118–123. 2006.PubMed/NCBI
4	Sayegh ME, Sano T, Dexter S, Katai H, Fukagawa T and Sasako M: TNM and Japanese staging systems for gastric cancer: How do they coexist? Gastric Cancer. 7:140–148. 2004. View Article : Google Scholar : PubMed/NCBI
5	Sobin LH and Wittekind C: UICC: TNM classification of malignant tumours (7th). Wiley-Liss. New York, NY: 2010.
6	Edge SBBD, Compton CC, Fritz AG, Greene FL and Trotti A: AJCC Cancer Staging Manual (7th). Springer. New York, NY: 2010.
7	Degiuli M, Sasako M, Ponti A, Vendrame A, Tomatis M, Mazza C, Borasi A, Capussotti L, Fronda G and Morino M: Italian Gastric Cancer Study Group: Randomized clinical trial comparing survival after D1 or D2 gastrectomy for gastric cancer. Br J Surg. 101:23–31. 2014. View Article : Google Scholar : PubMed/NCBI
8	Jiang L, Yang KH, Guan QL, Zhao P, Chen Y and Tian JH: Survival and recurrence free benefits with different lymphadenectomy for resectable gastric cancer: A meta-analysis. J Surg Oncol. 107:807–814. 2013. View Article : Google Scholar : PubMed/NCBI
9	Japanese Gastric Cancer Association: Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer. 14:101–112. 2011. View Article : Google Scholar : PubMed/NCBI
10	Bilimoria KY, Bentrem DJ, Ko CY, Ritchey J, Stewart AK, Winchester DP and Talamonti MS: Validation of the 6th edition AJCC pancreatic cancer staging system: Report from the national cancer database. Cancer. 110:738–744. 2007. View Article : Google Scholar : PubMed/NCBI
11	Japanese, Biliary, Tract, Cancers and Classification: Japanese classification of Biliary tract carcinoma. English edition Biliary Tract Cancer. 2015.
12	Furukawa H, Imamura H and Kodera Y: The role of surgery in the current treatment of gastric carcinoma. Gastric Cancer. 5(Suppl 1): S13–S16. 2002. View Article : Google Scholar
13	Tsubono Y and Hisamichi S: Screening for gastric cancer in Japan. Gastric Cancer. 3:9–18. 2000. View Article : Google Scholar : PubMed/NCBI
14	Shirong C, Jianhui C, Chuangqi C, Kaiming W, Xinhua Z, Wu S and Yulong H: Survival of proper hepatic artery lymph node metastasis in patients with gastric cancer: Implications for D2 lymphadenectomy. PloS One. 10:e01189532015. View Article : Google Scholar : PubMed/NCBI