DETECTION OF TUMOR DEPOSITS IN THE MESOGASTRIUM IN RESECTED GASTRIC CANCER PATIENTS

Tumor deposits in the mesogastrium

Abstract

Background: This study aims to determine the presence of tumor deposits in the mesogastrium of patients who underwent radical D2 gastrectomy with en bloc CME.

Methods: Thirteen consecutive gastric cancer patients who underwent radical gastrectomy with D2 dissection and CME at the Abdominal Surgical Department of the National Cancer Institute INEN (Lima, Peru) between March and April 2019 were prospectively incorporated. The presence of TDs was investigated and clinicopathological data were compared between positive TDs patients and negative TDs patients.

Results:  Thirteen patients entered the study, 10 of these patients were women, and 3 were male. The mean age of 56.3 years. Tumors were located at the middle third in 7 patients, at the distal third in 6 patients. Seven patients were diagnosed with diffuse-type and 6 patients with intestinal-type according to Lauren’s Classification.  The mean tumor size was 4.51cm (range :1.9cm-8cm). Patients were staged by the AJCC TNM 8^th Edition staging system, T4a (5 patients), T3 (5 patients), T1a (2 patients), and T1b (1 patient). Tumor deposits were found in 4 of 13 patients (30.7%). TDs were evidenced in locally advanced patients (pT3a and pT4a), 3 patients with lymphatic metastasis (pN1 and pN2), and in 1 patient without lymphatic metastasis (pN0).

Conclusions: In the present study is demonstrated that tumor deposits are present in surgical specimens of gastric cancer patients who underwent D2 Radical Gastrectomy associated with CME, the presence of tumor deposits is not exclusive of patients with nodal metastasis. Further studies are necessary to evaluate the importance of the presence of TDs in long-term survival.

Keywords: Complete mesogastrium excision (CME); Gastric Cancer; Tumor Deposit (TD).