Abstract
Introduction: The Japanese Gastric Cancer Association guidelines stipulate that D2 gastrectomy is required for treating advanced gastric cancer. However there is controversy regarding lymph node dissection around the splenic artery and hilum in advanced gastric carcinoma. The purpose of this study was to investigate the long-term prognosis and risk factors for splenic hilar lymph node metastasis(SHM) in patients with gastric cancer. Methods: A systematic search of PubMed, EMBASE, and Web of Science from January 1994 to June 2016 was conducted. All original studies comparing splenic hilar lymph node metastasis(metastasis group) to the non-metastasis(non-metastasis group) were included by critical appraisal. The following evaluated endpoints were assessed: prevalence of splenic hilar lymph node metastasis rate, 5 year overall survival rate and risk factors of SHM.Data synthesis and statistical analysis were carried out using R environment 3.0.1 software. Results: a total of 10 studies were included, representing 1,910 individuals. The pooled prevalence of lymph node metastasis at the splenic hilus was 16% (95% confidence intervals (CI): 5, 26%),in advanced proximal third gastric carcinoma. Compared with non-metastasis group, metastasis group had worse long-term prognosis [HR = 0.34, 95%CI(0.29, 0.42);P<0.05]. And our meta-analysis showed that, tumor located at greater curvature [RR = 0.49, 95%CI(0.37,0.65); P < 0.05],proximal third gastric carcinoma[RR = 0.49, 95%CI(0.29,0.83); P < 0.05], Borrmann IV [RR = 0.31, 95%CI(0.16,0.63); P < 0.05], depth of invasion T4 [RR = 0.31, 95%CI(0.22,0.43); phatic invasion [RR = 0.64, 95%CI(0.49,0.86); P < 0.05] and vascular invasion [RR = 0.44, 95%CI (0.22,0.87); P < 0.05] were statistically significantly associated with splenic hilar lymph node metastasis. Conclusion: The long-term prognosis of gastric cancer patients who had SHM was worse than those who had non-metastasis of splenic hilar lymph node. We identified risk factors consistently associated with SHM in patients with gastric cancer. These factors help to offer doctors postoperative clinical treatment for SHM in patients with gastric cancer.
Sign-in/Register to access full text options 
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.
