Skip to main content
Log in

Prognostic effect of lymph node micrometastasis in patients with histologically node-negative gastric cancer

  • Original Articles
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

There is no consensus as to the impact of lymph node micrometastasis on survival of patients with gastric cancer. The aim of this study was to clarify the prognostic significance of lymph node micrometastasis in patients with histologically node-negative gastric cancer

Methods

Lymph nodes (n=2039) from 64 patients with histologically node-negative gastric cancer (T2, T3) were evaluated for micrometastasis. Three serial 5-μm sections of the resected lymph nodes were prepared for immunohistochemical staining with the anti-cytokeratin antibody CAM 5.2.

Results

Micrometastasis was found in 73 of 2039 nodes (4%) and 20 of 64 patients (32%). The 5-year survival rate was significantly lower for patients with lymph node micrometastasis than for those without lymph node micrometastasis (66% vs. 95%,P<.01). The 5-year survival rate was significantly lower when there were four or more positive micrometastatic nodes (94% vs. 29%,P <.01) and when there were extragastric micrometastatic nodes (89% vs. 53%,P<.01).

Conclusions

Lymph node micrometastasis was associated with poor outcome in patients with histologically node-negative gastric cancer. The number and the level of lymph node micrometastases are useful prognostic markers for deciding treatment strategies for additional therapy and follow-up.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Bozzetti F, Bonfanti G, Morabito A et al. A multifactorial approach for the prognosis of patients with carcinoma of the stomach after curative resection.Surg Gynecol Obstet 1986;162:229–34.

    PubMed  CAS  Google Scholar 

  2. Maruyama K. The most important prognostic factors for gastric cancer patients: a study using univariate and multivariate analyses.Scand J Gastroenterol 1987;133(Suppl):63–8.

    Google Scholar 

  3. Adachi Y, Kamakura T, Mori M, Baba H, Maehara Y, Sugimachi K. Prognostic significance of the number of positive lymph nodes in gastric carcinoma.Br J Surg 1994;81:414–6.

    Article  PubMed  CAS  Google Scholar 

  4. Mori M, Mimori K, Inoue H, et al. Detection of cancer micrometastases in lymph nodes by reverse transcriptase-polymerase chain reaction.Cancer Res 1995;55:3417–20.

    PubMed  CAS  Google Scholar 

  5. Ishida K, Katsuyama T, Sugiyama A, Kawasaki S. Immunohistochemical evaluation of lymph node micrometastases from gastric carcinomas.Cancer 1997;79:1069–76.

    Article  PubMed  CAS  Google Scholar 

  6. Yamamoto N, Kato Y, Yanagisawa A, Ohta H, Takahashi T, Kitagawa T. Predictive value of genetic diagnosis for cancer micrometastasis: histologic and experimental appraisal.Cancer 1997; 80:1393–8.

    Article  PubMed  CAS  Google Scholar 

  7. Cai J, Ikeguchi M, Maeta M, Kaibara N. Micrometastasis in lymph nodes and microinvasion of the muscularis propria in primary lesions of submucosal gastric cancer.Surgery 1999;126:32–9.

    Google Scholar 

  8. Cai J, Ikeguchi M, Tsujitani S, Maeta M, Kaibara N. Micrometastasis in lymph nodes of mucosal gastric cancer.Gastric Cancer 2000;3:91–6.

    Article  PubMed  Google Scholar 

  9. Greenson JK, Isenhart CE, Rice R, Mojzisik C, Houchens D, Martin EW. Identification of occult micrometastases in pericolic lymph nodes of Dukes' B colorectal cancer patients using monoclonal antibodies against cytokeratin and CC49: correlation with long-term survival.Cancer 1994;73:563–9.

    Article  PubMed  CAS  Google Scholar 

  10. Sasaki M, Watanabe H, Jass JR, et al. Occult lymph node metastases detected by cytokeratin immunohistochemistry predict recurrence in “node-negative” colorectal cancer.J Gastroenterol 1997; 32:758–64.

    Article  PubMed  CAS  Google Scholar 

  11. Yasuda K, Adachi Y, Shiraishi N, Yamaguchi K, Hirabayashi Y, Kitano S. Pattern of lymph node micrometastasis and prognosis of patients with colorectal cancer.Ann Surg Oncol 2001;8:300–4.

    Article  PubMed  CAS  Google Scholar 

  12. Adachi Y, Yasuda K, Inomata M, Sato K, Shiraishi N, Kitano S. Pathology and prognosis of gastric carcinoma: well versus poorly differentiated type.Cancer 2000;89:1418–24.

    Article  PubMed  CAS  Google Scholar 

  13. Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma: 2nd English edition.Gastric Cancer 1998;1:10–24.

    Article  PubMed  Google Scholar 

  14. Makin CA, Bobrow LG, Bodmer WF. Monoclonal antibody to cytokeratin for use in routine histopathology.J Clin Pathol 1984; 37:975–83.

    PubMed  CAS  Google Scholar 

  15. Siewert JR, Kestlmeier R, Busch R, et al. Benefits of D2 lymph node dissection for patients with gastric cancer and pN0 and pN1 lymph node metastases.Br J Surg 1996;83:1144–7.

    Article  PubMed  CAS  Google Scholar 

  16. Fukagawa T, Sasako M, Mann GB, et al. Immunohistochemically detected micrometastases of the lymph nodes in patients with gastric carcinoma.Cancer 2001;92:753–60.

    Article  PubMed  CAS  Google Scholar 

  17. Kikuchi Y, Tsuchiya A, Ando Y, Yoshida T, Takenosita S. Immunohistochemical detection of lymph node microinvolvement in node-negative gastric cancer.Gastric Cancer 1999;2:173–8.

    Article  PubMed  Google Scholar 

  18. Nakajo A, Natsugoe S, Ishigami S, et al. Detection and prediction of micrometastasis in the lymph nodes of patients with pN0 gastric cancer.Ann Surg Oncol. 2001;8:158–62.

    Article  PubMed  CAS  Google Scholar 

  19. Cai J, Ikeguchi M, Maeta M, Kaibara N, Sakatani T. Clinicopathological value of immunohistochemical detection of occult involvement in pT3N0 gastric cancer.Gastric Cancer 1999;2:95–100.

    Article  PubMed  Google Scholar 

  20. Maehara Y, Oshiro T, Endo K, et al. Clinical significance of occult micrometastasis in lymph nodes from patients with early gastric cancer who died of recurrence.Surgery 1996;119:397–402.

    Article  PubMed  CAS  Google Scholar 

  21. Natsugoe S, Aikou T, Shimada M, et al. Occult lymph node metastasis in gastric cancer with submucosal invasion.Surg Today 1994;24:870–5.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kazuhiro Yasuda MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yasuda, K., Adachi, Y., Shiraishi, N. et al. Prognostic effect of lymph node micrometastasis in patients with histologically node-negative gastric cancer. Annals of Surgical Oncology 9, 771–774 (2002). https://doi.org/10.1007/BF02574499

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02574499

Key Words

Navigation