Influences of the Metastatic Lymph Node for Gastric Cancer Patients with Pritoneal Metastasis -Study on Intraperitoneal Lavage Cytology-

Kyoushi Tsuji, Katsuyuki Kunieda, Takashi Suhara, Motohisa Katoh, Yasuyuki Sugiyama, Takao Umemoto, Daizuo Fukada, Kiichi Miya, Shigitoyo Saji, Kuniyasu Shimokawa*

Second Department of Surgery, Department of Laboratory Medicine*, Gifu University School of Medicine

We studied the influence of lymph node metastasis of peritoneal metastasis of gastric cancer in 218 gastrectomized patients who underwent intraperitoneal lavage cytology at laparotomy. 1) The rate of positive cytology increased according to the extent of lymph node metastasis by dividing the patients into two groups, one without serosal invasion (t1, t2) and the other with serosal invasion (t3, t4), the relationship between lymph node metastasis and the rate of positive lavage cytology was determined. The positive cytology rate was significantly increased according to the extent of lymph node metastasis in the group with serosal invasion. However, all patients except one with metastasis of paraaortic lymph nodes showed a low positive rate in the group without serosal invasion. 2) The correlation between the number of metastatic lymph nodes, the area of serosal invasion and the incidence of peritoneal metastases including micro metastasis was examined in 74 patients including those with serosal invasion (t3, t4) and those with positive cytology without serosal invasion. The incidence of positive cytology in the group with 8 or more metastatic lymph nodes was significantly higher than in the group with 7 or fewer of metastatic lymph nodes. Also, the incidence of positive cytology of the group with a 20 cm² or larger area of serosal invasion was significantly higher than the group with an area less than 20 cm². In the group with a less than 20 cm² area, the incidence of peritoneal metastasis of the group with 8 or more of matastatic lymph nodes, was significantly higher than that of the group with 7 or fewer of matastatic lymph nodes. From the above results, we suspect that lymph node metastasis has some influence on peritoneal metastasis of gastric cancer.

Key words
gastric cancer, peritoneal metastasis, lavage cytology, lymph node metastasis

Reprint requests
Kyoushi Tsuji Second Department of Surgery, Gifu University School of Medicine
40 Tsukasa-machi, Gifu-city, 500 JAPAN

Accepted
June 11, 1997

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