Metastatic pathways of poorly differentiated gastric cancer

As we all know, cancer will metastasize at a certain time, and gastric cancer is no exception. Many patients want to know what are the metastatic pathways of gastric cancer and how it metastasizes? If gastric cancer metastasizes, how should it be treated? The following will specifically talk about the metastatic pathways and treatments of gastric cancer from these two aspects:

1. Lymph Node Metastasis

1. Metastasis: An important way for gastric cancer to spread, and it occurs relatively early. As the tumor grows, the deeper and wider it invades the stomach wall, the more chances it has of metastasis. It is divided into 3 stations or 3 groups according to the order of metastasis. The first group (station) is closest to the tumor and is the superficial group of lymph nodes attached to the stomach wall. It usually occurs when gastric cancer is confined to the submucosal layer. The second group (station) is the deep group of lymph nodes that drain the superficial lymph nodes. When gastric cancer invades the muscular layer, the second group of lymph node metastasis may occur. The third group (station) includes lymph nodes around the celiac artery, abdominal aorta, liver hilum, mesenteric root, and middle colic artery; distant lymph node metastasis may also occur, such as the left supraclavicular lymph nodes. This group of metastases often occurs when the tumor invades the serosa.

2. Treatment: Generally speaking, when the third group of lymph node metastasis occurs, the chance of radical cure has been lost.

2. Intraperitoneal Implantation and Metastasis of Gastric Cancer Cells

1. Metastasis: In a few cases, the cancer breaks through the serosa of the gastric wall, and the cancer tissue necrotizes and falls off, falling onto other organs and peritoneum, and implantation growth may occur. In the late stage, cancerous peritonitis may occur, with bloody ascites, and cancer cells can sometimes be found in the extracted ascites.

2. Treatment: Patients with implantation metastasis are all in the late stage, making treatment more difficult. They are often given chemotherapy drugs injected into the abdominal cavity, but due to extensive metastasis, they can only prolong life but cannot be cured.

3. Direct Spread

1. Metastasis: After the cancer grows and invades the stomach wall, it develops in depth, breaks through the serosa, and can directly invade adjacent organs and tissues, most commonly the greater omentum, liver, pancreas, and transverse colon, followed by the jejunum, diaphragm, and even the abdominal wall.

2. Treatment: Direct spread is related to the surgical method and whether radical resection is possible. Generally, when the spread is to adjacent organs such as the liver, surgical resection can be performed if the area is small and confined. However, when the area is large, it is difficult to completely remove the cancer.

4. Hematogenous metastasis

1. Metastasis: Some patients may have gastric cancer cells or cancer thrombi that spread to other organs throughout the body through the blood circulation. They may metastasize to the liver, lungs, bones, kidneys, spleen, brain, meninges, skin, and ovaries, forming ovarian Krukenberg carcinoma or ovarian mucinous cell carcinoma.

2. Treatment: Hematogenous metastasis often occurs in the late stage of gastric cancer. In addition to treating the primary lesion, the metastatic lesion must also be treated.

Editor's note: For everyone, it is important to learn more about cancer, improve awareness of cancer treatment and prevention, and ensure your own health.