P-114 - Do preoperative enlarged LNs affect the long-term outcome of laparoscopic radical gastrectomy for gastric cancer? ------A propensity score-matched case-control study

Abstract

Introduction: To investigated the oncologic efficacy of laparoscopic radical gastrectomy (LAG) for gastric cancer(GC) with preoperative enlarged lymph nodes (LNs). Methods: We prospectively collected data from 855 patients who underwent LAG for GC. Patients were divided into a large (>10 mm) and a small (≤10 mm) LN group (LG and SG) based on the long-axis diameter of the LN as measured preoperatively. The long-term outcomes were compared with the matched groups using a 1:1 propensity score matching method. Results: Before matching, the LG was associated with more LNs retrieved than the SG, whereas after matching, the number of LNs retrieved was similar between the two groups and remained similar with increases in the number of enlarged LN areas. Before matching, patients in the LG demonstrated a significantly lower 3-year overall survival rate than those in the SG (P < 0.001); additionally, in the LG, 3-year overall survival rates were similar among patients with a different total number of enlarged LN areas. After matching, the 3-year overall survival rate of the LG was close to that of the SG (81.1% vs. 72.4%, P = 0.066). A stratified analysis according to the only independent prognostic factor (pTNM stage) demonstrated that the 3-year overall survival rates of each stage were similar between the LG and SG. Conclusion: LAG is a procedure that is also safe and feasible for GC with preoperative enlarged LNs. Furthermore, the total number of areas with enlarged LNs had no impact on the long-term outcome of patients in the same tumor stage.