Triemstra, L. (2021) Pattern of lymph node metastases in gastric cancer patients: sub-analysis of a multicenter randomized controlled trial (LOGICA-trial). thesis, Medicine.
Full text available on request.Abstract
Background: gastrectomy with en-bloc D2-lymphadenectomy combined with perioperative chemotherapy is the standard curative treatment for advanced gastric cancer (AGC). A personalized surgical treatment varying in extent of lymphadenectomy based on N-stage is lacking. The aim was to determine the pattern of lymph node (LN) metastases per LN station in relation to clinical T-stage, Lauren classification and tumor location in resectable gastric cancer patients treated with perioperative chemotherapy. Methods: all patients with resectable gastric cancer treated with a D2-lymphadenectomy from the randomized LOGICA-trial (2015-2018) were analyzed. Primary outcomes included the incidence of LN metastases per LN station in relation to clinical T-stage, Lauren classification, tumor location and perioperative chemotherapy treatment. Results: in total 212 patients were included. LN metastases were found in 120 patients (57%) and perioperative chemotherapy was administered to 158 patients (75%). Higher incidences of LN metastases were found for higher clinical T-stage (cT3 and cT4) and diffuse type tumors. Furthermore, the primary tumor location seemed to be related to the location of the LN metastases. LN station 12 was involved with LN metastases for almost each clinical T-stage (even cT1N0 tumors), Lauren diffuse and intestinal type and each tumor location. Regression of LNs was induced in 25 patients (15%) and complete regression of the primary tumor in 14 patients (9%). Omental LN metastases were present in only 1 patient (0.5%) and omental tumor deposits in 5 patients (2%). Conclusion: we recommend a D2-lymphadenectomy for each patient to achieve radical resection. Future studies on the value of performing an omentectomy are needed to reach consensus on whether or not to perform an omentectomy.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Etten, Dr. B. van and Hillegersberg, Prof. dr. R. van and Ruurda, Prof. dr. J.P. and Jongh, Drs. C. de and Veen, Drs. A. van der |
| Faculty: | Medical Sciences |
| Date Deposited: | 23 Dec 2021 12:09 |
| Last Modified: | 23 Dec 2021 12:09 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2893 |
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