J Zhang1, S Zou1, R Luo1, Z Zhu1, Z Wang1, H Xu2, B Huang3. 1. Department of Surgical Oncology, First Affiliated Hospital of China Medical University, 16th Floor, 4th Building, No. 155, Nanjing North Street, Heping District, Shenyang, Liaoning, People's Republic of China. 2. Department of Surgical Oncology, First Affiliated Hospital of China Medical University, 16th Floor, 4th Building, No. 155, Nanjing North Street, Heping District, Shenyang, Liaoning, People's Republic of China. xuhuimian@126.com. 3. Department of Surgical Oncology, First Affiliated Hospital of China Medical University, 16th Floor, 4th Building, No. 155, Nanjing North Street, Heping District, Shenyang, Liaoning, People's Republic of China. bjhuang@cmu.edu.cn.
Abstract
PURPOSE: Radical gastrectomy with D2 lymphadenectomy has been widely recognized as standard surgical procedure for advanced gastric cancer, while the role of No. 14v lymphadenectomy in distal gastric cancer remains controversial. METHODS: Clinicopathological data of 793 distal gastric cancer patients who underwent at least a radical D2 lymphadenectomy with No. 6 nodes metastasis were retrospectively reviewed. RESULTS: Fifty patients received No. 14v lymphadenectomy. Patients with No. 14v nodes metastasis (21/50, 42.0%) had poor prognosis. The No. 14v nodes metastasis was not an independent prognostic factor (P = 0.075). In distal gastric cancer patients with No. 6 nodes metastasis, No. 14v lymphadenectomy deteriorated overall survival, what's more, No. 14v lymphadenectomy was an independent risk prognostic factor (hazard ratio: 1.404; 95% confidence interval 1.043-1.889; P = 0.025). There was no significant difference in overall or locoregional and other types of recurrence rate between the 14vD+ and the 14vD- groups. The proportion of complication rate was greater in 14vD+ group (P = 0.001). CONCLUSION: Extended D2 gastrectomy including No. 14v lymphadenectomy seems to be associated with poor overall survival and increased complication rate of distal gastric cancer patients with No. 6 nodes metastasis.
PURPOSE: Radical gastrectomy with D2 lymphadenectomy has been widely recognized as standard surgical procedure for advanced gastric cancer, while the role of No. 14v lymphadenectomy in distal gastric cancer remains controversial. METHODS: Clinicopathological data of 793 distal gastric cancerpatients who underwent at least a radical D2 lymphadenectomy with No. 6 nodes metastasis were retrospectively reviewed. RESULTS: Fifty patients received No. 14v lymphadenectomy. Patients with No. 14v nodes metastasis (21/50, 42.0%) had poor prognosis. The No. 14v nodes metastasis was not an independent prognostic factor (P = 0.075). In distal gastric cancerpatients with No. 6 nodes metastasis, No. 14v lymphadenectomy deteriorated overall survival, what's more, No. 14v lymphadenectomy was an independent risk prognostic factor (hazard ratio: 1.404; 95% confidence interval 1.043-1.889; P = 0.025). There was no significant difference in overall or locoregional and other types of recurrence rate between the 14vD+ and the 14vD- groups. The proportion of complication rate was greater in 14vD+ group (P = 0.001). CONCLUSION: Extended D2 gastrectomy including No. 14v lymphadenectomy seems to be associated with poor overall survival and increased complication rate of distal gastric cancerpatients with No. 6 nodes metastasis.
Authors: M Degiuli; M Sasako; A Ponti; A Vendrame; M Tomatis; C Mazza; A Borasi; L Capussotti; G Fronda; M Morino Journal: Br J Surg Date: 2014-01 Impact factor: 6.939