A Study on Resected Gastric Cancer with Left Supraclavicular Node Metastasis

Takao Suzuki, Takenori Ochiai, Matsuo Nagata, Yoshio Gunji, Kazuaki Nakajima, Miwako Arima, Teruo Kouzu, Yoshio Koide, Toshiyuki Kikuchi, Hiroshi Yamamoto, Kaichi Isono

The Second Department of Surgery, Chiba University School of Medicine

Diagnosis, treatment and prognosis of 7 resected gastric cancer patients with Virchow's node metastasis were investigated. One patient died of acute renal failure 2.5 months after operation and another patient had metachronous Virchow's node metastasis and survived for 118 months. The mean survival time for the patients except for these two patients was 10.8 months with 3 aliving patients. One patient in whom endoscopic ultrasonography revealed no sign of mediastinal node metastasis underwent total gastrectomy accompanied by lymph node dissection in the abdominal cavity and the neck. Eighteen months after the operation, he is alive and has no sign of recurrence. Two patients with mediastinal node metastasis were treated by high dose chemothrapy and autologous bone marrow transplantation. After the treatment Virchow's node and the mediastinal nodes disappeared. Therefore, for patients without an inoperable factor other than Virchow's metastasis, palliative gastrectomy and adjuvant therapy seemed to improved the prognosis for gastric cancer with Virchow's node metastasis. Furthermore for patients without mediastinal node metastasis, radical gastrectomy with lymph node dissection in the abdominal cavity and the neck is recommended.

Key words
Virchow's node metastasis of gastric cancer, diagnosis of mediastinal node metastasis by endoscopic ultrasonography, high dose cancer chemotherapy with autologous bone marrow transplantation

Reprint requests
Takao Suzuki The Second Department of Surgery, Chiba University School of Medicine
1-8-1 Inohana, Chuou-ku, Chiba-shi, 260 JAPAN

Accepted
September 9, 1992

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