title: Neoadjuvant chemotherapy followed by surgery in gastric cancer patients with extensive lymph node metastasis.
abstract: Gastric cancer with extensive lymph node metastasis (ELM) is usually considered unresectable and is associated with poor outcomes. Cases with clinical enlargement of the para-aortic lymph nodes and/or bulky lymph node enlargement around the celiac artery and its branches are generally dealt with as ELM. A standard treatment for gastric cancer with ELM has yet to be determined. Two phase II studies of neoadjuvant chemotherapy followed by surgery showed that neoadjuvant chemotherapy with S-1 plus cisplatin followed by surgical resection with extended lymph node dissection could represent a treatment option for gastric cancer with ELM. However, many clinical questions remain unresolved, including the criteria for diagnosing ELM, optimal regime, number of courses and extent of lymph node dissection.
authors.affiliation: Seiji Ito, Yuichi Ito, Kazunari Misawa, Yasuhiro Shimizu, Taira Kinoshita, Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi 464-8681, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Ito
authors.affiliation: Seiji Ito, Yuichi Ito, Kazunari Misawa, Yasuhiro Shimizu, Taira Kinoshita, Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi 464-8681, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ito
authors.affiliation: Seiji Ito, Yuichi Ito, Kazunari Misawa, Yasuhiro Shimizu, Taira Kinoshita, Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi 464-8681, Japan.
authors.forename: Kazunari
authors.initials: K
authors.lastname: Misawa
authors.affiliation: Seiji Ito, Yuichi Ito, Kazunari Misawa, Yasuhiro Shimizu, Taira Kinoshita, Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi 464-8681, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shimizu
authors.affiliation: Seiji Ito, Yuichi Ito, Kazunari Misawa, Yasuhiro Shimizu, Taira Kinoshita, Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi 464-8681, Japan.
authors.forename: Taira
authors.initials: T
authors.lastname: Kinoshita
keywords: Extended lymph node metastasis; Gastrectomy; Gastric cancer; Lymph node dissection; Neoadjuvant chemotherapy