Abstract
PurposeTo investigate upper stomach carcinoma risk factors for No. 10 lymph node (LN) metastasis, and establish a preoperative scoring system to predict No.10 LN metastasis.MethodBetween January 2011 and December 2014, we prospectively collected and retrospectively analyzed the data of 398 patients with upper-third gastric cancer (GC) who underwent laparoscopic spleen-preserving hilar lymph-node dissection (SHLND). We use the logistics regression analysis risk factors of No. 10 LN metastasis to establish and verify a scoring model.ResultAmong the 398 patients examined, 38 patients had No. 10 LN metastasis, yielding a 9.6% transfer rate. The preoperative risk factor analysis for No. 10 LN metastasis in the modeling group showed that tumor size, preoperative T staging, and preoperative N staging are independent risk factors. To establish a scoring system, we divided the modeling group of patients into three levels: low risk, intermediate risk, and high risk. The No. 10 LN metastasis rates of the low risk, intermediate risk and high risk groups were 2.84%, 13.9% and 34.9% respectively, with statistically significant (P < 0.001). The value for the area under the ROC curve of the scoring system was 0.820, and there were no statistically significant differences between the observed and predicted incidence rates for No. 10 LN metastasis in the validation set (P > 0.05).ConclusionThe scoring system comprising the tumor size, preoperative T stage and N stage is a simple and effective method to predict the risk of No. 10 LN metastasis and to preoperatively select cases suitable for laparoscopic spleen-preserving SHLND.
Highlights
For advanced proximal gastric cancer (GC), the No 10 lymph node (LN) is a crucial link in lymphatic drainage
The scoring system comprising the tumor size, preoperative T stage and N stage is a simple and effective method to predict the risk of No 10 LN metastasis and to preoperatively select cases suitable for laparoscopic spleen-preserving spleen-preserving hilar lymph-node dissection (SHLND)
According to 14th edition of the Japanese gastric cancer treatment guidelines, D2 lymphadenectomy is the standard procedure for advanced GC, and the No 10 LN should be dissected for the treatment of advanced upper GC
Summary
For advanced proximal gastric cancer (GC), the No 10 lymph node (LN) is a crucial link in lymphatic drainage. In 2008, the South Korean scholar Hyung et al [4] reported the first use of laparoscopic treatment to preserve the spleen during SHLND of upper GC, achieving a good curative effect and indicating that the operation is safe and feasible. The use of laparoscopic surgery to preserve the spleen during SHLND has increased [5]. This technology is difficult to implement in clinical practice because the spleen is deep, the operating space is narrow, and the splenic vessels are rich in this area and their branches are complex. We performed a retrospective study of patients subjected to laparoscopic spleenpreserving SHLND surgery to explore the preoperative factors associated with No 10 LN metastasis and establish a new scoring system to preoperatively predict the risk of No 10 LN metastasis
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
