title: Prognostic significance of morphological distribution of metastatic foci in lymph nodes with gastric cancer.
abstract: OBJECTIVE
  The morphological distribution of tumor cells in metastatic lymph nodes has been investigated in positive sentinel lymph nodes in several solid cancers. The aim of this study was to clarify the effect of the distribution of metastatic foci in lymph nodes on the prognosis in gastric cancer.
  
  
  METHODS
  The distribution of metastatic foci in the 100 node-positive patients who had undergone curative gastrectomy were classified into two groups: (1) massive type, in which the tumor occupied the entire lymph node, and (2) non-massive type, in which the tumor did not occupy the entire lymph node.
  
  
  RESULTS
  There were 38 patients in the massive type group and 62 patients in the non-massive type group. The 10-year survival rate was significantly poorer in the massive type group (p = 0.001). Multivariate analysis showed that distributional type and nodal status were independent prognostic factors. UICC N stage was subcategorized by distributional type, and survival was shown to be significantly worse in the massive type in the N1 group (p = 0.035).
  
  
  CONCLUSIONS
  It seems necessary to take the morphological distribution of metastatic foci into consideration when dealing with node-positive patients who had received curative resection for gastric cancer.
authors.affiliation: Department of Gastroenterological Surgery, Tokai University School of Medicine, Isehara, Japan. nakaken@is.icc.u-tokai.ac.jp
authors.forename: Kenji
authors.initials: K
authors.lastname: Nakamura
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Nabeshima
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Makuuchi
authors.forename: Kyoji
authors.initials: K
authors.lastname: Ogoshi
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary* / Q000601:surgery; D000368:Aged; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000556:secondary; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010534:Peritoneal Neoplasms / Q000556:secondary; D011379:Prognosis; D016016:Proportional Hazards Models; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery