title: Clinical significance of lymph node micrometastasis in gastric cancer.
abstract: Recently, the existence of lymph node micrometastasis (LNM), including isolated tumor cells, has been focused on during the development of molecular diagnostic tools for lymph node metastasis in various malignant neoplasms. In particular, immunohistochemistry and reverse transcription-polymerase chain reaction have been reported to be available for the detection of LNM in gastric cancer. However, at present, the clinical significance of LNM remains unclear in patients with gastric cancer. Therefore, we cannot strategically make light of this issue in clinical management. Currently, minimally invasive treatments, such as endoscopic submucosal dissection and laparoscopic surgery with personalized lymphadenectomy, are widely performed in consideration of postsurgical quality of life (QOL). However, it is important to maintain the balance between QOL and curability when selecting surgical treatments for patients with gastric cancer. If minimally invasive surgery based on LNM status was established for patients with early gastric cancer, it could be performed safely. We reviewed the clinical significance of LNM as an important strategic target in patients with gastric cancer.
authors.affiliation: Department of Digestive Surgery, Breast and Thyroid Surgery, Field of Oncology, Course of Advanced Therapeutics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Arigami
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Uenosono
authors.forename: Shigehiro
authors.initials: S
authors.lastname: Yanagita
authors.forename: Akihiro
authors.initials: A
authors.lastname: Nakajo
authors.forename: Sumiya
authors.initials: S
authors.lastname: Ishigami
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Okumura
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kijima
authors.forename: Shinichi
authors.initials: S
authors.lastname: Ueno
authors.forename: Shoji
authors.initials: S
authors.lastname: Natsugoe
mesh_terms: D006801:Humans; D008207:Lymphatic Metastasis; D061206:Neoplasm Micrometastasis; D011379:Prognosis; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery