Pattern of lymph node metastases in gastric cancer: a side-study of the multicenter LOGICA-trial

• DOI: 10.1007/s10120-022-01329-2
• Publication Date: 2022-09-14T11:03:00Z
• Authors: Cas de Jongh; Lianne Triemstra; Arjen van der Veen; Lodewijk A. A. Br...; Misha D. P. Luyer; Jan H. M. B. Stoot; Jelle P. Ruurda; Richard van Hille...; ; Hylke J. F. Brenkman; Maarten F. J. See...; Grard A. P. Nieuw...; Jeroen E. H. Ponten; Juul J. W. Tegels; Karel W. E. Hulsewe; Bas P. L. Wijnhoven; Sjoerd M. Lagarde; Wobbe O. de Steur; Henk H Hartgrink; Ewout A. Kouwenhoven; Marc J van Det; Eelco B Wassenaar; P. van Duijvendijk; Werner A. Draaisma; Ivo A. M. J. Broe...; Donald L. van der...; Suzanne S. Gisbertz
• Keywords: Surgical oncology; Lymphadenectomy

Abstract Background The relation between gastric cancer characteristics and lymph node (LN) metastatic patterns is not fully clear, especially following neoadjuvant chemotherapy (NAC). This study analyzed nodal patterns. Methods Individual LN stations were for all patients from the LOGICA-trial, a Dutch multicenter randomized trial comparing laparoscopic versus open D2-gastrectomy cancer. pattern of metastases per station was related to tumor location, cT-stage, Lauren classification NAC. Results Between 2015–2018, 212 underwent D2-gastrectomy, whom 158 (75%) received present in 120 (57%). Proximal tumors metastasized predominantly proximal (no. 1, 2, 7 9; p < 0.05), distal 5, 6 8; OR > 0.05). However, also stations, vice versa. Despite NAC, each 1–9, 11 12a) showed metastases, regardless histological subtype NAC treatment, including 12a cT1N0-tumors. more frequently diffuse intestinal (66% 52%; = 0,048), but cT3–4- cT1–2-stage (59% 51%; 0.259). similar these subgroups. Conclusions extent lymphadenectomy cannot be reduced after Although contained cT-stage (including cT1N0-tumors), subtype, or treatment. Therefore, D2-lymphadenectomy should routinely performed during gastrectomy Western patients.