nPTD classification: an updated classification of gastric cancer location for function preserving gastrectomy based on physiological lymphatic flow

Abstract Background The correlation between tumor location and lymphatic flow distribution in gastric cancer has been previously reported, and PTD (Proximal – Transitional – Distal) classification was proposed. Our group updated and developed the nPTD classification. Method We retrospectively studie...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Shinichi Kinami, Naohiko Nakamura, Tomoharu Miyashita, Hidekazu Kitakata, Sachio Fushida, Takashi Fujimura, Tohru Itoh, Hiroyuki Takamura
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Gastric cancer Sentinel node biopsy Lymphatic flow Function preserving gastrectomy Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/2d2e637ae4f24f4896f2e8dcc76453f8
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:2d2e637ae4f24f4896f2e8dcc76453f8
record_format	dspace
spelling	oai:doaj.org-article:2d2e637ae4f24f4896f2e8dcc76453f82021-11-21T12:30:26ZnPTD classification: an updated classification of gastric cancer location for function preserving gastrectomy based on physiological lymphatic flow10.1186/s12885-021-08936-91471-2407https://doaj.org/article/2d2e637ae4f24f4896f2e8dcc76453f82021-11-01T00:00:00Zhttps://doi.org/10.1186/s12885-021-08936-9https://doaj.org/toc/1471-2407Abstract Background The correlation between tumor location and lymphatic flow distribution in gastric cancer has been previously reported, and PTD (Proximal – Transitional – Distal) classification was proposed. Our group updated and developed the nPTD classification. Method We retrospectively studied gastric cancer patients who underwent the dye method sentinel node biopsy from 1993 to 2020. The inclusion criteria were a single lesion type 0 cancer of ≤5 cm in the long axis, clinically node-negative, and invasion within the proper muscle layer pathologically. In this study, the distribution of dyed lymphatic flow was evaluated for each occupied area of the tumor. Results We included 416 patients in this study. The tumors located in the watershed of the right and left gastroepiploic arteries near greater curvature had extensive lymphatic flow; therefore, a newly circular region with a diameter of 5 cm is set on the watershed of the greater curvature between P and T zone as the ‘n’ zone. In addition, for cancers located in the lesser P curvature, lymphatic flow to the greater curvature was not observed. Therefore, the P zone was divided into two: the lesser curvature side (PL) and the greater curvature side (PG). Conclusions The advantage of the nPTD classification is that it provides not only proper nodal dissection but also adequate function-preserving gastrectomy. If the tumor is localized within the PL, the proximal gastrectomy resection area can be further reduced. In contrast, for cancers located in the ‘n’ zone, near-total gastrectomy is required because of the extensive lymphatic flow.Shinichi KinamiNaohiko NakamuraTomoharu MiyashitaHidekazu KitakataSachio FushidaTakashi FujimuraTohru ItohHiroyuki TakamuraBMCarticleGastric cancerSentinel node biopsyLymphatic flowFunction preserving gastrectomyNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENBMC Cancer, Vol 21, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Gastric cancer Sentinel node biopsy Lymphatic flow Function preserving gastrectomy Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Gastric cancer Sentinel node biopsy Lymphatic flow Function preserving gastrectomy Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Shinichi Kinami Naohiko Nakamura Tomoharu Miyashita Hidekazu Kitakata Sachio Fushida Takashi Fujimura Tohru Itoh Hiroyuki Takamura nPTD classification: an updated classification of gastric cancer location for function preserving gastrectomy based on physiological lymphatic flow
description	Abstract Background The correlation between tumor location and lymphatic flow distribution in gastric cancer has been previously reported, and PTD (Proximal – Transitional – Distal) classification was proposed. Our group updated and developed the nPTD classification. Method We retrospectively studied gastric cancer patients who underwent the dye method sentinel node biopsy from 1993 to 2020. The inclusion criteria were a single lesion type 0 cancer of ≤5 cm in the long axis, clinically node-negative, and invasion within the proper muscle layer pathologically. In this study, the distribution of dyed lymphatic flow was evaluated for each occupied area of the tumor. Results We included 416 patients in this study. The tumors located in the watershed of the right and left gastroepiploic arteries near greater curvature had extensive lymphatic flow; therefore, a newly circular region with a diameter of 5 cm is set on the watershed of the greater curvature between P and T zone as the ‘n’ zone. In addition, for cancers located in the lesser P curvature, lymphatic flow to the greater curvature was not observed. Therefore, the P zone was divided into two: the lesser curvature side (PL) and the greater curvature side (PG). Conclusions The advantage of the nPTD classification is that it provides not only proper nodal dissection but also adequate function-preserving gastrectomy. If the tumor is localized within the PL, the proximal gastrectomy resection area can be further reduced. In contrast, for cancers located in the ‘n’ zone, near-total gastrectomy is required because of the extensive lymphatic flow.
format	article
author	Shinichi Kinami Naohiko Nakamura Tomoharu Miyashita Hidekazu Kitakata Sachio Fushida Takashi Fujimura Tohru Itoh Hiroyuki Takamura
author_facet	Shinichi Kinami Naohiko Nakamura Tomoharu Miyashita Hidekazu Kitakata Sachio Fushida Takashi Fujimura Tohru Itoh Hiroyuki Takamura
author_sort	Shinichi Kinami
title	nPTD classification: an updated classification of gastric cancer location for function preserving gastrectomy based on physiological lymphatic flow
title_short	nPTD classification: an updated classification of gastric cancer location for function preserving gastrectomy based on physiological lymphatic flow
title_full	nPTD classification: an updated classification of gastric cancer location for function preserving gastrectomy based on physiological lymphatic flow
title_fullStr	nPTD classification: an updated classification of gastric cancer location for function preserving gastrectomy based on physiological lymphatic flow
title_full_unstemmed	nPTD classification: an updated classification of gastric cancer location for function preserving gastrectomy based on physiological lymphatic flow
title_sort	nptd classification: an updated classification of gastric cancer location for function preserving gastrectomy based on physiological lymphatic flow
publisher	BMC
publishDate	2021
url	https://doaj.org/article/2d2e637ae4f24f4896f2e8dcc76453f8
work_keys_str_mv	AT shinichikinami nptdclassificationanupdatedclassificationofgastriccancerlocationforfunctionpreservinggastrectomybasedonphysiologicallymphaticflow AT naohikonakamura nptdclassificationanupdatedclassificationofgastriccancerlocationforfunctionpreservinggastrectomybasedonphysiologicallymphaticflow AT tomoharumiyashita nptdclassificationanupdatedclassificationofgastriccancerlocationforfunctionpreservinggastrectomybasedonphysiologicallymphaticflow AT hidekazukitakata nptdclassificationanupdatedclassificationofgastriccancerlocationforfunctionpreservinggastrectomybasedonphysiologicallymphaticflow AT sachiofushida nptdclassificationanupdatedclassificationofgastriccancerlocationforfunctionpreservinggastrectomybasedonphysiologicallymphaticflow AT takashifujimura nptdclassificationanupdatedclassificationofgastriccancerlocationforfunctionpreservinggastrectomybasedonphysiologicallymphaticflow AT tohruitoh nptdclassificationanupdatedclassificationofgastriccancerlocationforfunctionpreservinggastrectomybasedonphysiologicallymphaticflow AT hiroyukitakamura nptdclassificationanupdatedclassificationofgastriccancerlocationforfunctionpreservinggastrectomybasedonphysiologicallymphaticflow
_version_	1718418933600485376

nPTD classification: an updated classification of gastric cancer location for function preserving gastrectomy based on physiological lymphatic flow

Ejemplares similares