Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
권호 표지
DOI QR코드

DOI QR Code

Five-year Survival Associated with Stage I Gastric Cancer after Resection of Early Recurrence at Nodal Station No. 14v: a Case Report

  • Abe, Iku (Gastric Surgery Division, National Cancer Center Hospital East) ;
  • Kinoshita, Takahiro (Gastric Surgery Division, National Cancer Center Hospital East) ;
  • Kaito, Akio (Gastric Surgery Division, National Cancer Center Hospital East) ;
  • Sunagawa, Hideki (Gastric Surgery Division, National Cancer Center Hospital East) ;
  • Watanabe, Masahiro (Gastric Surgery Division, National Cancer Center Hospital East) ;
  • Sugita, Shizuki (Gastric Surgery Division, National Cancer Center Hospital East) ;
  • Tonouchi, Akiko (Gastric Surgery Division, National Cancer Center Hospital East) ;
  • Sato, Reo (Gastric Surgery Division, National Cancer Center Hospital East)
  • Received : 2017.02.21
  • Accepted : 2017.04.13
  • Published : 2017.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

The role of nodal station No. 14v (along the superior mesenteric vein) in lymphadenectomy for distal gastric cancer remains elusive. A 73-year-old woman underwent endoscopic submucosal dissection for gastric cancer, and was referred to our division for additional surgery because of pathologically non-curative resection. A laparoscopic distal gastrectomy with D1+ dissection was performed, with a final diagnosis of pT1bN1M0, Stage IB (2 nodal metastases to No. 6). Four months post-surgery, abdominal computed tomography revealed a 14-mm solitary nodule along the superior mesenteric vein. The lesion was excised and pathologically identified as a lymph node metastasis. Adjuvant chemotherapy with tegafur-gimeracil-oteracil potassium (S-1) was administered for the metastasis. Presently the patient survives without recurrence, 5.5 years after the second operation. Our findings suggest that there is lymphatic flow from the No. 6 to the No. 14v nodal station. Some patients with a No. 6 metastasis may benefit from a No. 14v lymphadenectomy, even in early-staged disease.

Keywords

References

  1. Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer 2011;14:113-123. https://doi.org/10.1007/s10120-011-0042-4
  2. Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2014 (ver. 4). Gastric Cancer 2017;20:1-19.
  3. Namieno T, Koito K, Higashi T, Shimamura T, Yamashita K, Kondo Y. Tumor recurrence following resection for early gastric carcinoma and its implications for a policy of limited resection. World J Surg 1998;22:869-873. https://doi.org/10.1007/s002689900484
  4. Saka M, Katai H, Fukagawa T, Nijjar R, Sano T. Recurrence in early gastric cancer with lymph node metastasis. Gastric Cancer 2008;11:214-218. https://doi.org/10.1007/s10120-008-0485-4
  5. Sano T, Sasako M, Kinoshita T, Maruyama K. Recurrence of early gastric cancer. Follow-up of 1475 patients and review of the Japanese literature. Cancer 1993;72:3174-3178. https://doi.org/10.1002/1097-0142(19931201)72:11<3174::AID-CNCR2820721107>3.0.CO;2-H
  6. Eom BW, Joo J, Park B, Kim YW. Reply to questions in response to "improved survival after adding dissection of the superior mesenteric vein lymph node (14v) to standard D2 gastrectomy for advanced distal gastric cancer". Surgery 2014;156:737-738. https://doi.org/10.1016/j.surg.2014.04.041
  7. An JY, Pak KH, Inaba K, Cheong JH, Hyung WJ, Noh SH. Relevance of lymph node metastasis along the superior mesenteric vein in gastric cancer. Br J Surg 2011;98:667-672. https://doi.org/10.1002/bjs.7414
  8. Kong SH, Yoo MW, Kim JW, Lee HJ, Kim WH, Lee KU, et al. Validation of limited lymphadenectomy for lower-third gastric cancer based on depth of tumour invasion. Br J Surg 2011;98:65-72. https://doi.org/10.1002/bjs.7266
  9. Masuda TA, Sakaguchi Y, Toh Y, Aoki Y, Harimoto N, Taomoto J, et al. Clinical characteristics of gastric cancer with metastasis to the lymph node along the superior mesenteric vein (14v). Dig Surg 2008;25:351-358. https://doi.org/10.1159/000165382
  10. Koizumi W, Narahara H, Hara T, Takagane A, Akiya T, Takagi M, et al. S-1 plus cisplatin versus S-1 alone for first-line treatment of advanced gastric cancer (SPIRITS trial): a phase III trial. Lancet Oncol 2008;9:215-221. https://doi.org/10.1016/S1470-2045(08)70035-4

Cited by

  1. Risk factors for metastasis to No.14v lymph node and prognostic value of 14v status for gastric cancer patients after surgery vol.48, pp.4, 2017, https://doi.org/10.1093/jjco/hyy006
  2. “D2 plus” lymphadenectomy is associated with improved survival in distal gastric cancer with clinical serosa invasion: a propensity score analysis vol.9, pp.1, 2017, https://doi.org/10.1038/s41598-019-55535-7