caa a22 4500 445336307 CHVBK 20180317142756.0 cr unu---uuuuu 170323e20110801xx s 000 0 eng 10.1245/s10434-010-1547-5 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1547-5 Tumor Site and Perigastric Nodal Status are the Most Important Predictors of Para-Aortic Nodal Involvement in Advanced Gastric Cancer [Elektronische Daten] [Giovanni de Manzoni, Alberto Di Leo, Franco Roviello, Daniele Marrelli, Simone Giacopuzzi, Anna Minicozzi, Giuseppe Verlato] Background: This study was designed to identify pathological predictors of para-aortic nodal invasion in advanced gastric cancer. Methods: Between 1990 and 2007, 294 patients with advanced gastric cancer underwent gastrectomy with D2 lymphadenectomy+para-aortic nodal dissection in Siena and Verona, Italy. Results: Forty-seven (16%) patients had para-aortic node metastases. Of these, 91%, 88%, and 74%, respectively, also had metastases at stations No. 3, No. 1, and No. 7. Para-aortic node metastases were never observed when stations No. 1 and No. 3 were both negative. Patients were divided into three groups, according to the risk of para-aortic node invasion: (1) high-risk group (n=24, 8.2%), presenting a 42% risk and comprising T3/T4 cancers with mixed/nonintestinal histology, arising from the upper third; (2) low-risk group (n=138, 46.9%), presenting a 0-10% risk and including middle-lower third tumors—either T2 irrespective of histology, or T3/T4 with intestinal histology; (3) intermediate-risk group, comprising all other patients (n=132, 44.9%). Their risk ranged between 16% and 30%, but increased up to 21-37.5% after excluding 33 patients with negative No. 1 and No. 3 stations. Conclusions: The combination of tumor site, histology, and T stage with perigastric nodal status allowed identification of patients at higher risk of para-aortic nodal invasion who could benefit from para-aortic nodal dissection. Society of Surgical Oncology, 2011 de Manzoni Giovanni First Division of General Surgery, University of Verona, Verona, Italy aut Di Leo Alberto Unit of General Surgery, Arco Hospital, APSS of Trento, Trento, Italy aut Roviello Franco Division of Surgical Oncology, University of Siena, Siena, Italy aut Marrelli Daniele Division of Surgical Oncology, University of Siena, Siena, Italy aut Giacopuzzi Simone First Division of General Surgery, University of Verona, Verona, Italy aut Minicozzi Anna First Division of General Surgery, University of Verona, Verona, Italy aut Verlato Giuseppe Unit of Epidemiology and Medical Statistics, University of Verona, Verona, Italy aut Annals of Surgical Oncology Springer-Verlag 18/8(2011-08-01), 2273-2280 1068-9265 18:8<2273 2011 18 10434 https://doi.org/10.1245/s10434-010-1547-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1547-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- de Manzoni Giovanni First Division of General Surgery, University of Verona, Verona, Italy aut NATIONALLICENCE 700 1- Di Leo Alberto Unit of General Surgery, Arco Hospital, APSS of Trento, Trento, Italy aut NATIONALLICENCE 700 1- Roviello Franco Division of Surgical Oncology, University of Siena, Siena, Italy aut NATIONALLICENCE 700 1- Marrelli Daniele Division of Surgical Oncology, University of Siena, Siena, Italy aut NATIONALLICENCE 700 1- Giacopuzzi Simone First Division of General Surgery, University of Verona, Verona, Italy aut NATIONALLICENCE 700 1- Minicozzi Anna First Division of General Surgery, University of Verona, Verona, Italy aut NATIONALLICENCE 700 1- Verlato Giuseppe Unit of Epidemiology and Medical Statistics, University of Verona, Verona, Italy aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/8(2011-08-01), 2273-2280 1068-9265 18:8<2273 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer