Lymph node spread in the short gastric mesentery after total gastrectomy for stomach cancer
Lymph Node Metastasis and Tumor Deposit in the Short Gastric Mesentery Following Total Gastrectomy With D2 Lymphadenectomy Plus Complete Mesogastric Excision for Gastric Cancer: A Prospective Observational Study
This project will examine removed short gastric mesentery tissue to see how often cancer has spread to those lymph nodes in people having total gastrectomy for gastric cancer.
Quick facts
| Study type | Observational |
|---|---|
| Enrollment | 150 (estimated) |
| Ages | 18 Years to 85 Years |
| Sex | All |
| Sponsor | First Affiliated Hospital of Zhejiang University Academic / other |
| Drugs / interventions | chemotherapy |
| Locations | 1 site (Hangzhou, Zhejiang) |
| Trial ID | NCT06728878 on ClinicalTrials.gov |
What this trial studies
This observational study enrolls patients with primary gastric adenocarcinoma who undergo total gastrectomy with D2 lymphadenectomy plus complete mesogastric excision. During surgery the short gastric mesenteries (No.4sa and No.10 groups) will be anatomically separated and submitted for pathological examination. Pathologists will record lymph node counts and positivity rates for each short gastric mesentery and the team will analyze correlations with tumor location and stage. The goal is to generate evidence to help standardize which short gastric mesenteric lymph nodes should be removed during total gastrectomy.
Who should consider this trial
Good fit: Adults aged 18–85 with primary gastric adenocarcinoma staged cT2–4aN0–3M0 who are planned for total gastrectomy with D2 lymphadenectomy plus complete mesogastric excision, ASA class I–III, without prior neoadjuvant therapy or prior upper abdominal surgery, and who consent are ideal candidates.
Not a fit: Patients with negative preoperative biopsy, very advanced disease (cT4b or metastatic), BMI >30 kg/m2, prior neoadjuvant chemo/radiotherapy or previous upper abdominal surgery, other active malignancies, or who refuse the operation are unlikely to benefit from participation.
Why it matters
Potential benefit: If successful, the results could help surgeons target lymph node removal more precisely during total gastrectomy, improving staging accuracy and potentially avoiding unnecessary tissue removal.
How similar studies have performed: Existing guidelines endorse D2 lymphadenectomy, but detailed, specimen-level data on metastasis rates for individual short gastric mesenteries are limited, making this focused analysis relatively novel.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: 1. Aged older than 18 years and younger than 85 years 2. Primary gastric adenocarcinoma confirmed by preoperative pathology result 3. cT2-4aN0-3M0 at preoperative evaluation according to the American Joint 8 Committee on Cancer (AJCC) Cancer Staging Manual 8th Edition 4. Patients who received total gastrectomy with D2 lymphadenectomy plus complete mesogastric excision 5. American Society of Anesthesiologists (ASA) class I, II, or III 6. Written informed consent Exclusion Criteria: 1. Negative preoperative biopsy 2. Too late tumour stage or metastasis (cT4b/M1) 3. BMI\>30 kg/m2 4. previous neoadjuvant chemotherapy or radiotherapy 5. Previous upper abdominal surgery 6. Combined with other malignant diseases 7. Reject operation
Where this trial is running
Hangzhou, Zhejiang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine — Hangzhou, Zhejiang, China (Recruiting)
Study contacts
- Study coordinator: Tao Wang, Ph.d
- Email: 15002740874@163.com
- Phone: +86-197-068-25286
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.