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The effect of spleen-preserving lymphadenectomy on surgical outcomes of locally advanced proximal gastric cancer

Authors
 SUNG JIN OH  ;  WOO JIN HYUNG  ;  CHEN LI  ;  JYEWON SONG  ;  WOOKHO KANG  ;  SUN YOUNG RHA  ;  HYUN CHEOL CHUNG  ;  SEUNG HO CHOI  ;  SUNG HOON NOH 
Citation
 JOURNAL OF SURGICAL ONCOLOGY, Vol.99(5) : 275-280, 2009 
Journal Title
JOURNAL OF SURGICAL ONCOLOGY
ISSN
 0022-4790 
Issue Date
2009
MeSH
Adenocarcinoma/mortality ; Adenocarcinoma/pathology ; Adenocarcinoma/secondary ; Adenocarcinoma/surgery* ; Adult ; Contraindications ; Female ; Follow-Up Studies ; Gastrectomy ; Humans ; Length of Stay ; Lymph Node Excision/methods* ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Recurrence, Local/surgery* ; Postoperative Hemorrhage/etiology ; Prognosis ; Prospective Studies ; Spleen ; Splenectomy*/adverse effects ; Splenectomy*/mortality ; Stomach Neoplasms/mortality ; Stomach Neoplasms/pathology ; Stomach Neoplasms/surgery* ; Survival Rate ; Treatment Outcome
Keywords
gastric cancer ; spleen-preserving ; surgical outcome
Abstract
BACKGROUND: The aim of this study was to investigate the effects of D2 lymphadenectomy with spleen preservation on surgical outcomes in locally advanced proximal gastric cancer. METHODS: Between January 2000 and December 2004, a total of 366 patients who underwent curative total gastrectomy were studied retrospectively from a prospectively designed database. RESULTS: The spleen-preservation group experienced shorter operation times, a lower incidence of perioperative transfusion, and shorter postoperative hospital stays. Perioperative transfusion and splenectomy were independent risk factors for morbidity. There was no significant difference between the two groups in recurrence or cumulative survival rate when adjusted according to cancer stage. Multivariate analysis showed that tumor size, serosal invasion, and nodal metastasis were independent prognostic factors, while splenectomy was not. The cumulative survival rate in pN0-status patients was significantly higher in the spleen-preservation group, while there was no significant difference in the survival of pN1- or pN2-status patients between the two groups. CONCLUSIONS: Splenectomy for lymph node dissection in proximal gastric cancer patients obviously showed poor short-surgical outcomes, but it did not affect long-term outcomes in terms of recurrence and overall survival rate. Therefore, spleen-preserving lymphadenectomy is a feasible method for radical surgery in locally advanced proximal gastric cancer.
Full Text
http://onlinelibrary.wiley.com/doi/10.1002/jso.21229/abstract
DOI
10.1002/jso.21229
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Wook Ho(강욱호)
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Rha, Sun Young(라선영) ORCID logo https://orcid.org/0000-0002-2512-4531
Song, Jye Won(송재원)
Oh, Sung Jin(오성진)
Chung, Hyun Cheol(정현철) ORCID logo https://orcid.org/0000-0002-0920-9471
Choi, Seung Ho(최승호) ORCID logo https://orcid.org/0000-0002-9872-3594
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/103728
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