Metastasis of gastric cancer

The metastasis of gastric cancer includes lymphatic metastasis, hematogenous metastasis, direct infiltration, and implantation metastasis. Among them, lymphatic metastasis is the most common and occurs earlier. Clarifying the status of lymphatic metastasis is of great significance for deciding the treatment plan. This article mainly introduces the lymphatic metastasis grouping and infiltration station of gastric cancer.

1. Grouping of perigastric lymph nodes The commonly used lymph node grouping method is as follows: (No.1) right area of ​​the cardia, (No.2) left area of ​​the cardia, (No.3) along the lesser curvature of the stomach, (No.4) lymph nodes of the greater curvature, (No.5) suprapyloric area, (No.6) subpyloric area, (No.7) around the left gastric artery trunk, (No.8) around the common hepatic artery trunk, (No.9) around the celiac artery, (No.10) splenic hilum, (No.11) splenic artery trunk, (No.12) hepatoduodenal ligament, (No.13) behind the pancreatic head and duodenum, (No.14) lymph nodes around the superior mesenteric vessels,

2. The substations of perigastric lymph nodes are divided into three stations according to the scope of lymph node removal and the order of metastasis: the lymph nodes along the lesser and greater curvatures of the stomach are the first station; the groups around the abdominal cavity, left stomach, common liver, and splenic artery are the second station; the rest are the third station.

Common sites of distant lymph node metastasis from gastric cancer include the supraclavicular lymph nodes and the left supraclavicular lymph nodes or both supraclavicular lymph nodes (Virchow lymph nodes). Gastric cancer in women metastasizes through the lymphatics or directly spreads to the ovaries to form metastatic mucinous carcinoma called Krurenberg tumor.