Solitary lymph node metastasis in gastric carcinoma

To study solitary lymph node metastatic route of gastric carcinoma and its management.Methods Data of 49 gastric carcinoma patients proved to have solitary lymph node metastasis were analyzed retrospectively.Patients were divided into skip metastasis group and no-skip metastasis group according to lymph node metastasis location.Clinical and pathological features and prognosis were compared between these two groups.Results The rate of solitary lymph node metastasis in gastric cancer was 13.5% and skip metastasis was 4.4%.In no-skip metastasis group solitary lymph node metastasis was usually found in No.3 and No.6 group of lymph nodes,while No.7 group was commonly involved in cases of skip metastasis.There were 16 cases in skip metastasis group with 14 cases in the N2 nodes and 2 cases in N3 nodes (both were in No.12 group).Jumping solitary node involvement was correlated statistically with the degree of wall invasion (χ2=5.08,P=0.016) and the size of the tumor (t=2.215,P=0.032) compared with no-skip metastasis group.Recurrence rate and 5-year survival rate in skip and no-skip group were found to be of no significant difference,respectively.Conclusion Solitary lymph node metastasis is mainly in the perigastric region,while jumping solitary node involvement is common along the left gastric artery and may be correlated with the depth of invasion and tumor size.Radical resection with D2 and No.12 lymphadenectomy may decrease the residual rate of jumping node involvement.6 refs,1 tab.