Presence of cancer cells in the periarterial tissues of patients with advanced gastric cancer

Yamamoto,Hiroshi; Murata,Satoshi; Kaida,Sachiko; Yamaguchi,Tsuyoshi; Ishida,Mitsuaki; Kushima,Ryoji; Tani,Masaji

doi:10.3892/ol.2018.8704

Presence of cancer cells in the periarterial tissues of patients with advanced gastric cancer

Authors:
- Hiroshi Yamamoto
- Satoshi Murata
- Sachiko Kaida
- Tsuyoshi Yamaguchi
- Mitsuaki Ishida
- Ryoji Kushima
- Masaji Tani
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Affiliations: Department of Gastrointestinal Surgery, Kusatsu General Hospital, Kusatsu, Shiga 525‑8585, Japan, Department of Surgery, Shiga University of Medical Science, Otsu, Shiga 520‑2192, Japan, Division of Diagnostic Pathology, Kansai Medical University, Hirakata, Osaka 573‑1191, Japan, Department of Clinical Laboratory Medicine, Shiga University of Medical Science, Otsu, Shiga 520‑2192, Japan
Published online on: May 11, 2018 https://doi.org/10.3892/ol.2018.8704
Pages: 1226-1230

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Abstract

Lymphadenectomy with gastrectomy is considered a curative surgical treatment for gastric cancer. Periarterial connective tissue‑preserving lymphadenectomy has become a common procedure following developments in laparoscopic surgery. However, the presence of cancer cells in the periarterial tissue, including neural invasion, has not been examined. In the present study, the periarterial tissues from the vessel roots of the left gastric artery (LGA) and right gastroepiploic artery (RGEA) after gastrectomy were evaluated for the presence of cancer cells. The study included 28 consecutive patients who underwent gastrectomy for gastric cancer. The vessel roots of the RGEA and LGA were obtained from surgically resected specimens and examined by two independent pathologists to determine the presence of cancer cells in the periarterial tissues. The collected specimens included 23 RGEA roots and 26 LGA roots from 28 patients. In 8 cases of early gastric cancer, no cancer cells were indicated in the periarterial tissues. By contrast, cancer cells, including neural invasion in 2 cases, were identified in the periarterial tissues from the roots of examined gastric arteries in 3/20 (15%) cases of advanced gastric cancer. Notably, all 3 cases featured multiple regional lymph node (LN) metastases. Cancer cells were detected in the perivascular tissue of the major gastric arteries from cases with advanced gastric cancer with LN metastases, suggesting the requirement for oncologic evaluation to ensure adequate vascular tissue margins and an adequate periarterial layer during lymphadenectomy.

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