title: Location of tumor and distribution of lymph node metastasis in gastric cancer: lesser curve or greater curve.
abstract: BACKGROUND
  The aim of this study was to clarify the relationship between the location of tumor and distribution of lymph node metastasis in node-positive gastric cancer. Pathologic findings of tumors in which location of tumors or positive nodes was confined within the lesser or greater curve were evaluated, and candidates of limited resection were assessed.
  
  
  METHODS
  A total of 211 patients with node-positive gastric cancer treated by D2 or D3 gastrectomy was studied. Location, size, gross type, and histologic type of tumors, presence or absence of serosal, lymphatic, and vascular invasions, and status of lymph node metastasis were investigated. Tumors were divided into lesser curve tumors, greater curve tumors, and others; and lymph node metastases were classified as lesser curve metastasis, greater curve metastasis, and both curves metastasis.
  
  
  RESULTS
  Lesser or greater curve tumors were featured by small size, negative serosal invasion, negative vascular invasion, metastasis confined to the perigastric nodes, and number of positive nodes less than seven. Cases of lesser or greater curve metastasis were featured by tumor location within the lesser or greater curve, small size, grossly superficial type, negative serosal invasion, negative lymphatic invasion, and number of positive nodes less than seven. When size of lesser or greater curve tumors was less than 4 cm, lymph node metastasis was mostly restricted to the same lesser or greater curve.
  
  
  CONCLUSIONS
  Among node-positive gastric cancers, tumors located within the lesser or greater curve were characterized by small size, negative serosal invasion, and a few metastases confined to the perigastric lymph nodes. When tumor size was less than 4 cm and tumor invasion was not into serosa, lesser or greater curve tumors rarely extend into lymph nodes along the other curve. Limited resection or less invasive treatment is acceptable for such small gastric cancers along the lesser or greater curve.
authors.affiliation: First Department of Surgery, Oita Medical University, Hasama-machi, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Adachi
authors.forename: N
authors.initials: N
authors.lastname: Shiraishi
authors.forename: M
authors.initials: M
authors.lastname: Inomata
authors.forename: K
authors.initials: K
authors.lastname: Yasuda
authors.forename: Y
authors.initials: Y
authors.lastname: Hirabayashi
authors.forename: S
authors.initials: S
authors.lastname: Kitano
mesh_terms: D005743:Gastrectomy; D006801:Humans; D008207:Lymphatic Metastasis; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery