title: Clinical significance of the pattern of lymph node metastasis depending on the location of gastric cancer.
abstract: OBJECTIVE
  When performing a laparoscopic assisted gastrectomy, a function-preserving gastrectomy is performed depending on the location of the primary gastric cancer. This study examined the incidence of lymph node metastasis by the lymph node station number by tumor location to determine the optimal extent of the lymph node dissection.
  
  
  METHODS
  The subjects consisted of 1,510 patients diagnosed with gastric cancer who underwent a gastrectomy between 1996 and 2005. The patients were divided into three groups: upper, middle and lower third, depending on the location of the primary tumor. The lymph node metastasis patterns were analyzed in the total and early gastric cancer patients.
  
  
  RESULTS
  In all patients, lymph node station numbers 1, 2, 3, 7, 10 and 11 metastases were dominant in the cancer originating in the upper third, whereas station numbers 4, 5, 6 and 8 were dominant in the lower third. In early gastric cancer patients, the station number of lymph nodes with a metastasis did not show a significant difference in stage pT1a disease. On the other hand, a metastasis in lymph node station number 6 was dominant in stage pT1b disease that originated in the lower third of the stomach.
  
  
  CONCLUSIONS
  When performing a laparoscopic-assisted gastrectomy for early gastric cancer, a limited lymphadenectomy is considered adequate during a function-preserving gastrectomy in mucosal (T1a) cancer. On the other hand, for submucosal (T1b) cancer, a number 6 node dissection should be performed when performing a pylorus preserving gastrectomy.
authors.affiliation: Department of Surgery, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Ki Bin
authors.initials: KB
authors.lastname: Han
authors.forename: You Jin
authors.initials: YJ
authors.lastname: Jang
authors.forename: Jong Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Sung Soo
authors.initials: SS
authors.lastname: Park
authors.forename: Seong Heum
authors.initials: SH
authors.lastname: Park
authors.forename: Seung Joo
authors.initials: SJ
authors.lastname: Kim
authors.forename: Young Jae
authors.initials: YJ
authors.lastname: Mok
authors.forename: Chong Suk
authors.initials: CS
authors.lastname: Kim
references.citation: J Surg Oncol. 2009 Apr 1;99(5):275-80
references.pmid: 19152367
references.citation: Virchows Arch. 2009 Feb;454(2):143-51
references.pmid: 19104832
references.citation: Semin Surg Oncol. 2003;21(1):23-9
references.pmid: 12923913
references.citation: World J Surg. 2004 Sep;28(9):857-61
references.pmid: 15593456
references.citation: Endoscopy. 2009 Feb;41(2):118-22
references.pmid: 19214889
references.citation: J Am Coll Surg. 2006 Aug;203(2):162-9
references.pmid: 16864028
references.citation: World J Gastroenterol. 2009 Nov 14;15(42):5352-9
references.pmid: 19908346
references.citation: Gastric Cancer. 2008;11(3):131-3
references.pmid: 18825307
references.citation: Gastric Cancer. 2008;11(3):134-48
references.pmid: 18825308
references.citation: Dig Surg. 2009;26(5):378-83
references.pmid: 19923825
references.citation: J Surg Oncol. 2008 Dec 1;98(7):500-4
references.pmid: 18770520
references.citation: Ann Surg Oncol. 2010 May;17(5):1259-66
references.pmid: 20217252
references.citation: Surg Endosc. 2010 Sep;24(9):2343-8
references.pmid: 20376493
references.citation: Ann Surg Oncol. 2009 Jan;16(1):61-7
references.pmid: 18998065
references.citation: Ann Surg Oncol. 2009 Dec;16(12):3252-8
references.pmid: 19639365
references.citation: Surg Today. 2010 Mar;40(3):228-33
references.pmid: 20180075
references.citation: Eur J Surg Oncol. 2009 Mar;35(3):281-8
references.pmid: 18342480
references.citation: Gastric Cancer. 1998 Dec;1(1):10-24
references.pmid: 11957040
references.citation: Ann Surg Oncol. 2009 Jun;16(6):1507-13
references.pmid: 19347407
references.citation: Am J Surg. 2008 Oct;196(4):587-91
references.pmid: 18519129
references.citation: Ann Surg. 2009 Jun;249(6):942-7
references.pmid: 19474686
references.citation: Surg Endosc. 2009 Feb;23(2):377-83
references.pmid: 18443861