Objective To evaluate the status of lymph node metastasis and reasonable procedure in gastric cancer. Methods The incidence of metastases from gastric cancer to various regional lymph node stations was studied in 1 505 patients with gastric cancer. The patients underwent surgical resection from January 1995 to December 2004.Results Lymph node metastasis were observed in 928 of 1 505 cases (61.7%). Lymph node metastasis frequency was found in groups No.1 （32.9%），No.3 （28.7%）， No.2 （20.4%）， and No.7 （18.6%） at upper third stomach cancer；in groups No.3 （32.5%）， No.4 （24.7%）， No.7 （20.6%）， and No.1 （17.3%） at middle third stomach cancer； in groups No.6 （33.7%）， No.3 （31.3%）， No.4 （25.6%）， and No.7 （21.5%） at lower third stomach cancer. Conclusions Distribution of metastatic lymph node is clearly related to the location of the tumor. Anatomical extent of lymph node metastases in gastric cancer provid surgical guidance for surgeons.
Objective To systematically review the prognostic significance of extranodal extension in gastric cancer, esophageal cancer and gastroesophageal junction cancer. Methods We searched EMbase, The Cochrane Library (Issue 9, 2016), PubMed, CBM, CNKI, VIP and WanFang Data databases from inception to August 2016, to collect cohort studies about the prognostic significance of extranodal extension. Two reviewers independently screened literature, extracted data and evaluated the risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.2 software. Results A total of 16 studies involving 9 445 participants were included. The results of meta-analysis showed that for gastric cancer patients, the overall survival (OS) (HR=1.71, 95%CI 1.49 to 2.00,P<0.000 01), disease free survival (DFS) (HR=1.39, 95%CI 1.12 to 1.73,P=0.003) and cancer specific survival (HR=1.52, 95%CI 1.18 to 1.96,P=0.001) in ENE(+) group were lower than ENE(–) group. For esophageal cancer and gastroesophageal junction cancer patients, the overall survival (OS) (HR=1.84, 95%CI 1.49 to 2.27,P<0.000 01), disease free survival (DFS) (HR=2.18, 95%CI 1.70 to 2.81,P<0.000 01) and cancer specific survival (HR=1.73, 95%CI 1.19 to 2.52,P=0.004) in ENE(+) group were lower than ENE(–) group. Conclusion Current evidence indicates that ENE(+) was correlated with a poor prognosis in gastric cancer, esophageal cancer and gastroesophageal junction cancer patients. Due to the quantity and quality limitations of included studies, more high quality cohort studies are needed to verify the above conclusions.