title: Clinical characteristics of gastric cancer with metastasis to the lymph node along the superior mesenteric vein (14v).
abstract: OBJECTIVE
  We investigated the clinical significance of metastasis to the lymph node (LN) along the superior mesenteric vein (14v) in gastric cancer.
  
  
  METHODS
  A retrospective study of 2,513 gastrectomy patients with a 14v dissection was done using the Ganken Igan Database.
  
  
  RESULTS
  The incidence of 14v metastasis correlated with tumor location, depth of tumor invasion, regional LN metastases, peritoneal metastasis, peritoneal cytology-positive, hepatic metastasis and postoperative recurrence (p < 0.01). Metastases to the infra-pyloric LN (6), supra-pyloric LN (5) and left para-cardial LN (2) were independent variables affecting 14v metastasis (p < 0.05), and the 6 status was a useful predictive factor for a 14v-negative status with a low false-negative rate (1.9%). The patients with 14v metastasis after curative surgery demonstrated a significantly lower survival rate than those without (5-year overall survival rate; 11.3 vs. 60.2%, p < 0.0001). In them, LN around the abdominal aorta (16)-positive group showed a significantly lower survival rate than the negative group (p < 0.05).
  
  
  CONCLUSIONS
  Advanced gastric cancer with invasion to the lower stomach often metastasizes to 14v, and the 6 status can predict 14v negative. Most patients with 14v metastasis have a poor prognosis, similar to those with systemic metastasis, although some such patients may benefit from a curative dissection.
authors.affiliation: Department of Gastroenterological Surgery, National Kyushu Cancer Center, Minami-ku, Fukuoka, Japan. takaakimas@ybb.ne.jp
authors.forename: Taka-aki
authors.initials: TA
authors.lastname: Masuda
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Sakaguchi
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Toh
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Aoki
authors.forename: Norifumi
authors.initials: N
authors.lastname: Harimoto
authors.forename: Junya
authors.initials: J
authors.lastname: Taomoto
authors.forename: Osamu
authors.initials: O
authors.lastname: Ikeda
authors.forename: Takefumi
authors.initials: T
authors.lastname: Ohga
authors.forename: Eisuke
authors.initials: E
authors.lastname: Adachi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Okamura
mesh_terms: D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008499:Medical Records; D008642:Mesenteric Veins; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*