Applicability of the Proposed Japanese Model for the Classification of Gastric Cancer Location: The “PROTRADIST” Retrospective Study
Background: The extension of lymphadenectomy for surgical treatment of gastric cancer remains discordant among European and Japanese surgeons. Kinami et al. (Kinami S, Fujimura T, Ojima E, et al. PTD classification: proposal for a new classification of gastric cancer location based on physiological...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2017-05-01
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| Series: | Journal of Investigative Surgery |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/08941939.2016.1230248 |
| _version_ | 1797684634447773696 |
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| author | Luigi Marano Marianna Petrillo Modestino Pezzella Alberto Patriti Bartolomeo Braccio Giuseppe Esposito Michele Grassia Angela Romano Francesco Torelli Raffaele De Luca Alessio Fabozzi Giuseppe Falco Natale Di Martino |
| author_facet | Luigi Marano Marianna Petrillo Modestino Pezzella Alberto Patriti Bartolomeo Braccio Giuseppe Esposito Michele Grassia Angela Romano Francesco Torelli Raffaele De Luca Alessio Fabozzi Giuseppe Falco Natale Di Martino |
| author_sort | Luigi Marano |
| collection | DOAJ |
| description | Background: The extension of lymphadenectomy for surgical treatment of gastric cancer remains discordant among European and Japanese surgeons. Kinami et al. (Kinami S, Fujimura T, Ojima E, et al. PTD classification: proposal for a new classification of gastric cancer location based on physiological lymphatic flow. Int. J. Clin. Oncol. 2008;13:320–329) proposed a new experimental classification, the “Proximal zone, Transitional zone, Distal zone” (PTD) classification, based on the physiological lymphatic flow of gastric cancer site. The aim of the present retrospective study is to assess the applicability of PTD Japanese model in gastric cancer patients of our Western surgical department. Methods: Two groups of patients with histologically documented adenocarcinoma of the stomach were retrospectively obtained: In the first group were categorized 89 patients with T1a–T1b tumor invasion; and in the second group were 157 patients with T2–T3 category. The data collected were then categorized according to the PTD classification. Results: In the T1a–T1b group there were no lymph node metastases within the r-GA or r-GEA compartments for tumors located in the P portion, and similarly there were no lymphatic metastases within the l-GEA or p-GA compartments for tumors located in the D portion. On the contrary, in the T2–T3 group the lymph node metastases presented a diffused spreading with no statistical significance between the two classification models. Conclusions: Our results show that the PTD classification based on physiological lymphatic flow of the gastric cancer site is a more physiological and clinical version than the Upper, Medium And Lower classification. It represents a valuable and applicable model of cancer location that could be a guide to a tailored surgical approach in Italian patients with neoplasm confined to submucosa. Nevertheless, in order to confirm our findings, larger and prospective studies are needed. |
| first_indexed | 2024-03-12T00:32:33Z |
| format | Article |
| id | doaj.art-cd9455b8cf694a5dbf76c4da8e050969 |
| institution | Directory Open Access Journal |
| issn | 0894-1939 1521-0553 |
| language | English |
| last_indexed | 2024-03-12T00:32:33Z |
| publishDate | 2017-05-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Investigative Surgery |
| spelling | doaj.art-cd9455b8cf694a5dbf76c4da8e0509692023-09-15T10:12:26ZengTaylor & Francis GroupJournal of Investigative Surgery0894-19391521-05532017-05-0130321021610.1080/08941939.2016.12302481230248Applicability of the Proposed Japanese Model for the Classification of Gastric Cancer Location: The “PROTRADIST” Retrospective StudyLuigi Marano0Marianna Petrillo1Modestino Pezzella2Alberto Patriti3Bartolomeo Braccio4Giuseppe Esposito5Michele Grassia6Angela Romano7Francesco Torelli8Raffaele De Luca9Alessio Fabozzi10Giuseppe Falco11Natale Di Martino12Division of Multidisciplinary Robotic SurgerySecond University of NaplesSecond University of NaplesDivision of Multidisciplinary Robotic SurgerySecond University of NaplesSecond University of NaplesSecond University of NaplesSecond University of NaplesSecond University of NaplesNational Cancer Research Centre, Istituto Tumori “G. Paolo IIFatebenefratelli HospitalIRCCS-Arcispedale Santa Maria NuovaSecond University of NaplesBackground: The extension of lymphadenectomy for surgical treatment of gastric cancer remains discordant among European and Japanese surgeons. Kinami et al. (Kinami S, Fujimura T, Ojima E, et al. PTD classification: proposal for a new classification of gastric cancer location based on physiological lymphatic flow. Int. J. Clin. Oncol. 2008;13:320–329) proposed a new experimental classification, the “Proximal zone, Transitional zone, Distal zone” (PTD) classification, based on the physiological lymphatic flow of gastric cancer site. The aim of the present retrospective study is to assess the applicability of PTD Japanese model in gastric cancer patients of our Western surgical department. Methods: Two groups of patients with histologically documented adenocarcinoma of the stomach were retrospectively obtained: In the first group were categorized 89 patients with T1a–T1b tumor invasion; and in the second group were 157 patients with T2–T3 category. The data collected were then categorized according to the PTD classification. Results: In the T1a–T1b group there were no lymph node metastases within the r-GA or r-GEA compartments for tumors located in the P portion, and similarly there were no lymphatic metastases within the l-GEA or p-GA compartments for tumors located in the D portion. On the contrary, in the T2–T3 group the lymph node metastases presented a diffused spreading with no statistical significance between the two classification models. Conclusions: Our results show that the PTD classification based on physiological lymphatic flow of the gastric cancer site is a more physiological and clinical version than the Upper, Medium And Lower classification. It represents a valuable and applicable model of cancer location that could be a guide to a tailored surgical approach in Italian patients with neoplasm confined to submucosa. Nevertheless, in order to confirm our findings, larger and prospective studies are needed.http://dx.doi.org/10.1080/08941939.2016.1230248gastric cancerlymphatic compartmentgastrectomylymph node dissectionlymphadenectomytumor location |
| spellingShingle | Luigi Marano Marianna Petrillo Modestino Pezzella Alberto Patriti Bartolomeo Braccio Giuseppe Esposito Michele Grassia Angela Romano Francesco Torelli Raffaele De Luca Alessio Fabozzi Giuseppe Falco Natale Di Martino Applicability of the Proposed Japanese Model for the Classification of Gastric Cancer Location: The “PROTRADIST” Retrospective Study Journal of Investigative Surgery gastric cancer lymphatic compartment gastrectomy lymph node dissection lymphadenectomy tumor location |
| title | Applicability of the Proposed Japanese Model for the Classification of Gastric Cancer Location: The “PROTRADIST” Retrospective Study |
| title_full | Applicability of the Proposed Japanese Model for the Classification of Gastric Cancer Location: The “PROTRADIST” Retrospective Study |
| title_fullStr | Applicability of the Proposed Japanese Model for the Classification of Gastric Cancer Location: The “PROTRADIST” Retrospective Study |
| title_full_unstemmed | Applicability of the Proposed Japanese Model for the Classification of Gastric Cancer Location: The “PROTRADIST” Retrospective Study |
| title_short | Applicability of the Proposed Japanese Model for the Classification of Gastric Cancer Location: The “PROTRADIST” Retrospective Study |
| title_sort | applicability of the proposed japanese model for the classification of gastric cancer location the protradist retrospective study |
| topic | gastric cancer lymphatic compartment gastrectomy lymph node dissection lymphadenectomy tumor location |
| url | http://dx.doi.org/10.1080/08941939.2016.1230248 |
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