A New N Category for Cardia Cancer Based on Lymph Node Compartments

摘要

Background: There remains controversy over the concept of rational lymphadenectomy for cardia cancers. Methods: A series of 656 patients with a cardia cancer are reviewed, including squamous cell carcinoma and adenocarcinoma. The regional lymph nodes were classified into three Compartments based on the metastatic rates and the 5-year-sur-vival rates. Results: The Compartment-I and -II nodes were the perigastric nodes, the left gastric artery nodes, and the celiac nodes. The Compart-ment-in nodes were the thoracic paraesophageal nodes, the pyloric nodes, and the abdominal paraaortic nodes. Conclusion: The Compartment-I land -II nodes can be resected by proximal gastrectomy with partial iesophagectomy through a mediastinoabdominal approach, while to resect the Compartment-III nodes, total gastrectomy with lower esophagectomy through a left thoracoabdominal approach is needed.