Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
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Is Lymph Node Size a Reliable Factor for Estimating Lymph Node Metastasis in Early Gastric Cancer?

  • Kim, Dong Jin (Department of Surgery, The Catholic University of Korea St. Paul's Hospital, The Catholic University of Korea College of Medicine) ;
  • Kim, Wook (Department of Surgery, The Catholic University of Korea Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine)
  • Received : 2017.09.14
  • Accepted : 2017.11.28
  • Published : 2018.03.31
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Abstract

Purpose: Pre-operative lymph node (LN) size is a valuable parameter for determining treatment strategy for gastric cancer. However, a correlation between LN size and metastasis has not been established. Materials and Methods: Thirty-six LN-positive (LNP) and matched 36 LN-negative (LNN) patients were included, and pathology slides of the LNs of these patients were reviewed. All the LNs were measured along the long-axis (LA) and short-axis (SA), manually. Results: Average retrieved LNs were $37.3{\pm}19.8$ and $40.5{\pm}11.6$ in the LNN and LNP groups, respectively. In total 2,800 LNs, including 136 metastatic LNs (MLNs) and 2,664 non-metastatic LNs (nMLNs), were evaluated. Mean length was significantly more in MLNs along both, the LA and SA (MLN_LA vs. nMLN_LA: $4.97{\pm}3.84$ vs. $3.37{\pm}2.40mm$, MLN_SA vs. nMLN_SA: $3.86{\pm}3.19$ vs. $2.43{\pm}1.59mm$; P<0.001). However, 92.6% (126/136) and 95.6% (130/136) of MLNs were <10 mm along the LA and SA, respectively. In addition, only 22.2% of the LNP group exhibited an MLN as the largest LN. Conclusions: Pre-operative multi-detector computed tomography has limited ability in estimating the presence of metastasis in LNs because most MLNs are less than 10 mm, and only a small proportion of the LNP group exhibits an MLN as the largest MLN.

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