Key clinical point: Routine D2-lymphadenectomy should be performed during total and distal gastrectomy in patients with gastric cancer even after administering neoadjuvant chemotherapy (NAC).
Major finding: cT2, cT3, and cT4 stage tumors metastasized to all individual lymph node (LN) stations (1-9, 11, and 12a). Patients who did vs did not receive NAC had a numerically lower incidence of metastases in almost all stations (54% vs 63%) but a similar distribution of LN metastases over the different stations.
Study details: This side-study of the LOGICA trial included 212 patients with resectable gastric cancer who underwent total or distal D2-gastrectomy with en-bloc D2-lymphadenectomy combined with total omentectomy, of which 158 received NAC and 120 had LN metastases.
Disclosures: The LOGICA trial was sponsored by ZonMw (The Netherlands Organization for Health Research and Development); this side-study received no funding. Some authors declared serving as consultants or advisors for or receiving research funding and travel or accommodation fees and expenses from various sources.
Source: de Jongh C et al and the LOGICA Study Group. Pattern of lymph node metastases in gastric cancer: A side-study of the multicenter LOGICA-trial. Gastric Cancer. 2022 (Sep 14). Doi: 10.1007/s10120-022-01329-2