Abstract
The aim of this study was to elucidate the potential impact of “D2 plus” lymphadenectomy on the long-term survival of distal gastric cancer (GC) patients with clinical serosa invasion. A total of 394 distal GC patients with clinical serosa invasion who underwent at least standard D2 lymphadenectomy were enrolled. Patients were categorized into two groups according to the extent of lymphadenectomy: D2 group and “D2 plus” group. Propensity score matching was used to adjust for the differences in baseline characteristics. In the multivariate analysis for the whole study series, extent of lymphadenectomy was an independent prognostic factor for GC patients (P = 0.011). With the strata analysis, the significant prognostic differences between the two groups were only observed in patients at the IIIa-b or N1-3a stages. After matching, patients in “D2 plus” group still demonstrated a significantly higher 5-year overall survival rate than those in D2 group (55.3% versus 43.9%, P = 0.042). The common therapeutic value index of No. 12b, No. 12p, No. 14v and No. 13 LNs was 4.6, which was close to that of No. 5 LN station. In conclusion, “D2 plus” lymphadenectomy may be associated with improved overall survival in distal GC with clinical serosa invasion.
Highlights
The aim of this study was to elucidate the potential impact of “D2 plus” lymphadenectomy on the longterm survival of distal gastric cancer (GC) patients with clinical serosa invasion
We focused on distal GC with clinical serosa invasion, which was at higher risk of lymph node (LN) metastases beyond D2 range
It had been confirmed that LNs located in the hepatoduodenal ligament, posterior of pancreatic head or root of superior mesenteric vein were often involved in distal GC with serosa invasion[12,17,18,19]
Summary
The aim of this study was to elucidate the potential impact of “D2 plus” lymphadenectomy on the longterm survival of distal gastric cancer (GC) patients with clinical serosa invasion. The 5-year OS rate was significantly lesser for GC patients with 12b or 12p LNs metastases than those without (13.3% versus 35.1%, P = 0.022) These studies specially focused on a single LN station such as 12b, 12p, 14v or No 13 LN, and the prognostic value of dissection of multiple LNs beyond D2 range was rarely evaluated. The aim of this study was to elucidate the prognostic value of “D2 plus” lymphadenectomy including 12b, 12p, 14v and No 13 LN dissection in distal GC patients with clinical serosa invasion after curative surgery by means of multivariate Cox regression and propensity score matching analyses
Sign-in/Register to view highlights & summary 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.
