title: Distant nodal metastasis: is it always an unresectable disease?
abstract: This article aims at analyzing the published literature concerning the treatment of patients with gastric cancer and distant nodal metastases, actually considered metastatic disease. A systematic search was undertaken using Medline, Embase, Cochrane and Web-of-Science libraries. No specific restriction on year of publication was used; preference was given to English papers. Both clinical series and literature reviews were selected. Only 11 papers address the issue of surgery for nodal basins outside the D2 dissection area. From these papers, in selected cases extended surgery may prove useful in prolonging survival, when a comprehensive therapeutic pathway including chemotherapy is scheduled. In conclusion, in presence of nodal metastases outside the loco-regional nodes, surgery may be considered for metastatic nodes in stations 13 and 16, in selected cases.
authors.affiliation: Department of Clinical and Experimental Sciences, Surgical Clinic, University of Brescia, Brescia, Italy.
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: Baiocchi
authors.affiliation: Department of Clinical and Experimental Sciences, Surgical Clinic, University of Brescia, Brescia, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Celotti
authors.affiliation: Department of Clinical and Experimental Sciences, Surgical Clinic, University of Brescia, Brescia, Italy.
authors.forename: Sarah
authors.initials: S
authors.lastname: Molfino
authors.affiliation: Department of Clinical and Experimental Sciences, Surgical Clinic, University of Brescia, Brescia, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Baggi
authors.affiliation: Department of Clinical and Experimental Sciences, Surgical Clinic, University of Brescia, Brescia, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Tarasconi
authors.affiliation: Department of Clinical and Experimental Sciences, Surgical Clinic, University of Brescia, Brescia, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Baronio
authors.affiliation: Department of General and Minimally Invasive Surgery, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg.
authors.forename: Luca
authors.initials: L
authors.lastname: Arru
authors.affiliation: Department of Clinical and Experimental Sciences, Surgical Clinic, University of Brescia, Brescia, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Gheza
authors.affiliation: Department of Clinical and Experimental Sciences, Surgical Clinic, University of Brescia, Brescia, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Tiberio
authors.affiliation: Department of Clinical and Experimental Sciences, Surgical Clinic, University of Brescia, Brescia, Italy.
authors.forename: Nazario
authors.initials: N
authors.lastname: Portolani
keywords: Gastric cancer; TNM; nodal metastases; staging; stomach