BACKGROUND: The role of para-aortic lymph node (PALN) dissection for far-advanced gastric cancer is controversial in patients with clinical PALN positivity who have responded to chemotherapy. MATERIALS AND METHODS: We retrospectively analyzed long-term outcomes of patients with pathologically-positive PALNs who underwent radical gastrectomy. RESULTS: The 3- and 5-year overall survival (OS) rates of 65 pathologically PALN-positive patients who underwent PALN dissection (n=704) were 33.8% and 21.2%, respectively. Multivariable analysis revealed the following poor prognostic factors: nodal involvement around the celiac axis (hazard ratio (HR)=4.04, 95% confidence interval (CI)=1.55-9.63), tumor diameter of ≥120 mm (HR=3.37; 95% CI=1.18-9.63) and ≥3 PALNs involved (HR=2.24; 95% CI=1.21-4.15). Patients with none of these factors survived significantly longer than those with any of these factors (5-year OS=87.5% versus 9.3%, respectively; p<0.001). CONCLUSION: Pathologically PALN-positive patients achieve long survival; however, the indications for PALN dissection should be carefully considered. Copyright
BACKGROUND: The role of para-aortic lymph node (PALN) dissection for far-advanced gastric cancer is controversial in patients with clinical PALN positivity who have responded to chemotherapy. MATERIALS AND METHODS: We retrospectively analyzed long-term outcomes of patients with pathologically-positive PALNs who underwent radical gastrectomy. RESULTS: The 3- and 5-year overall survival (OS) rates of 65 pathologically PALN-positive patients who underwent PALN dissection (n=704) were 33.8% and 21.2%, respectively. Multivariable analysis revealed the following poor prognostic factors: nodal involvement around the celiac axis (hazard ratio (HR)=4.04, 95% confidence interval (CI)=1.55-9.63), tumor diameter of ≥120 mm (HR=3.37; 95% CI=1.18-9.63) and ≥3 PALNs involved (HR=2.24; 95% CI=1.21-4.15). Patients with none of these factors survived significantly longer than those with any of these factors (5-year OS=87.5% versus 9.3%, respectively; p<0.001). CONCLUSION: Pathologically PALN-positive patients achieve long survival; however, the indications for PALN dissection should be carefully considered. Copyright
Authors: Shu-Bei Wang; Wei-Xiang Qi; Jia-Yi Chen; Cheng Xu; Wei-Guo Cao; Rong Cai; Lu Cao; Gang Cai Journal: Front Oncol Date: 2021-04-01 Impact factor: 6.244