J.Jpn. Surg. Soc.. 82(6): 612-621, 1981

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Original article

QUANTITATIVE STATISTICAL STUDIES ON LYMPH NODE METASTASIS OF GASTRIC CARCINOMA, WITH REFERENCE TO ITS RELATIONSHIP WITH PRIMARY LESION AND PROGNOSIS

The relationship between primary lesions and lymph nodes with metastasis was studied in order to perform a rational lymph node dissection at the operation for gastric carcinoma. The lymph node metastasis was analized through the following approach on 625 cases of gastric carcinoma, to which radical operations were performed.
1. Rate of Metastasis (RM): No. of cases with lymph node metastasis/No. of cases of lymph node dissection
2. Frequency of Metastasis (FM): No. of metastasized node/No. of dissected nodes
3. No. of metastasized nodes (NM)
4. 5-year survival rates in terms of RM, FM and NM
The RM, FM and NM increased with the depth of invasion of the primary lesion into the gastric wall. The more infiltrative the gross appearance of primary lesions were, the higher the RM, FM and NM were. In the group with vascular invasion determined histologically or undifferentiated adenocarcinoma, the RM, FM and NM were higher than that of the group without vascular invasion or well differentiated carcinoma, respectively. The RM, FM and NM were proved to largely contribute to the prognosis. The FM and NM were found to have close relationship to the prognosis especially in cases with lymph node metastasis. Five year survival rates of cases, in which the metastasis was evidenced less than two lymph nodes, were evaluated. There was no difference between the cases with the lymph node metastasis limited in only perigastric region and the cases with the lymph node metastasis over the perigastric region, i.e. the lymph nodes around the left gastric artery, the caeliac artery and the common hepatic artery.

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