J.Jpn. Surg. Soc.. 95(12): 860-865, 1994

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Original article

EVALUATION OF MEDICINAL LYMPH NODE DISSECTION IN ADVANCED GASTRIC CANCER

In order to improve the results of surgical treatment in advanced gastric cancer, we performed preoperatie targeted chemotherapy for metastatic lymph nodes. The solution which contained aclarubicin adsorbed on activated carbon was submucously injected around gastric tumor under endscopic observation 2-7 days prior to the operation. We termed this method medicinal lymph node dissection (MLD). Our standerd surgical treatment (SST) for gastric cancer consists of gastrectomy and extended lymph node dissection (N₁ and N₂ lymph nodes). Patients of curative resection with histologically positive lymph node metastasis were enrolled, as the subjects. We compared the cumulative survival rate in 47 patients treated with SST+MLD (MLD group) with that in 125 patients treated with SST only (control group).
Five year survival rates in the MLD and control groups were 60% and 48%, respectively. The MLD group showed significantly higher survival rate in patients with N₃, N₄ and infrapyloric lymph node metastasis.
A significant difference of the survival rate suggests the efficacy of SST+MLD against micrometastasis in N₃ and para-aortic lymph nodes. The SST+MLD therapy is recommended to the advanced gastric cancer, especially in the lower third of the stomach.

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