Clinico-pathological Studies on Para-aortic Lymph Node Metastasis and Postoperative Quality of Life in Gastric Cancer Patients

Masatsugu Kitamura, Kuniyoshi Arai, Yoshiaki Iwasaki

Department of Surgery, Tokyo Metropolitan Komagome Hospital

The advantage of para-aortic lymph node (No. 16) dissection and quality of life was studied from the viewpoint of clinico-pathological findings and their prognosis. No. 16 lymph nodes were dissected in 343 cases, and metastasis was seen in 79 (23.0%). The metastatic rate increased with the depth of cancer. High metastatic rates were seen in types 3 and 4, and in the histologically undifferentiated type. The five year survival rate of patients with No. 16 metastasis (P₀ and H₀) was 18.8%. The n₃ (-) group among cases with n₄, (+) group showed a significantly better outcome than the n₃, (+) group (p<0.05). Concerning the relationship between No. 16 dissection and QOL, blood loss was greater and the length of surgery was longer than in the No. 16 non-dissected group. Serum alubumin in the No. 16 dissected group was significantly decreased on the 7th and 14th day. The exudate volume from drainage of the No. 16 dissected group was much higher than in the non-dissected group on the first and second postoperative day. Body weight in the dissected group decreased further than in the non-dissected group. The extent of ingesting foods was slightly worse in the No. 16 dissected group and the duration from discharge to work was longer than in the non-dissected group. Postoperative complications in the No. 16 dissected group were the same as in the non-dissected group. In conclusion, it is considered that No. 16 lymph node dissection does not have an obvious disadvantage for patients from the viewpoint of prognosis and postoperative QOL.

Key words
para-aortic lymph node metastasis, para-aortic lymph node dissection, gastric cancer, complication, quality of life

Reprint requests
Masatsugu Kitamura Department of Surgery, Tokyo Metropolitan Komagome Hospital
3-18-22, Honkomagome, Bunkyo-ku, Tokyo, 113 JAPAN

Accepted
December 7, 1994

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