Lymph Node Metastasis and Treatment for Gastric Cancer According to Prediction of Metastasis

Kyoji Ogoshi, Kenji Nakamura, Masao Miyaji, Kunihiro Iwata, Yasumasa Kondoh, Tomoo Tajima, Toshio Mitomi

Second Department of Surgery, Tokai University

We examined HLA antigens in 564 patients who underwent resection of gastric cancer, and reported that HLA-DR4 antigen was associated with and increased the risk of lymph node metastasis in patients with poorly differentiated adenocarcinoma, if corrected p values were tested. Therefore, we futher investigated whether HLA-DR4 antigens could act as a predictor of the efficacy of treatment for gastric cancer according to the risk of lymph node metastasis. The 5-year survival rates of gastric cancer patients with and without HLA-DR4 antigen were 85.4% and 94.0%, respectively, and those of patients with poorly differentiated adenocarcinoma with and without this antigen were 59.5% and 83.1%, respectively. The difference between them was significant. Among patients without hepatic metastasis and peritoneal dissemination receiving complete removal of the lymph node, patients with tumor localized in the antrum and cardia showed no distant lymph node metastasis except along the left gastric artery. These patients are indicated for minimum removal of the lymph node (D1+ #7).

Key words
HLA-DR4 antigen, gastric cancer, lymph node metastasis

Reprint requests
Kyoji Ogoshi Second Department of Surgery, Tokai University
Bohseidai, Isehara, 259-11 JAPAN

Accepted
July 6, 1994

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