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Impact of splenic hilar lymph node metastasis on prognosis in patients with advanced gastric cancer

 Taeil Son  ;  In Gyu Kwon  ;  Joong Ho Lee  ;  Youn Young Choi  ;  Hyoung-Il Kim  ;  Jae-Ho Cheong  ;  Sung Hoon Noh  ;  Woo Jin Hyung 
 Oncotarget, Vol.8(48) : 84515-84528, 2017 
Journal Title
Issue Date
D2 lymphadenectomy ; gastric cancer ; prognosis ; splenic hilar lymph node
Background: Impact of splenic hilar LN dissection during total gastrectomy for proximal advanced gastric cancer is controversial. The objective of this study was to assess the impact on prognosis of splenic hilar lymph node(LN) metastasis compared to that of metastasis to other regional LN groups. Study Design: Patients who underwent total gastrectomy with D2 LN dissection from 2000 to 2010 were reviewed retrospectively. The clinicopathologic characteristics and long-term results of patients with splenic hilar LN metastasis were compared to those of patients with only metastasis to other extraperigastric LNs (stations #8a, #9, #11, or #12a). To investigate the survival benefit of performing splenic hilar LN dissection, the estimated therapeutic index for the procedure was calculated by multiplying the incidence of metastases in the hilar region by the survival rates for individuals with nodal involvement in that region. Results: Of 602 patients, 87(14.5%) had hilar LN metastasis. The 5-year overall and relapse-free survival rates for patients with hilar LN metastasis were 24.1% and 12.1%, respectively. These rates were similar to those for patients with metastasis to other extraperigastric LNs (P > 0.05), with similar recurrence patterns. Overall survival in the hilar LN metastasis group was better than that for patients with distant metastasis(P < 0.05). The estimated therapeutic index of splenic hilar LN dissection was 3.5, which was similar to index values for LN dissection at other extraperigastric LNs. Conclusions: Dissection of splenic hilar LNs during total gastrectomy for advanced gastric cancer allows for a prognosis similar to that achieved with dissection of extraperigastric LNs.
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1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
Yonsei Authors
김형일(Kim, Hyoung Il) ORCID logo https://orcid.org/0000-0002-6134-4523
노성훈(Noh, Sung Hoon) ORCID logo https://orcid.org/0000-0003-4386-6886
손태일(Son, Tae Il) ORCID logo https://orcid.org/0000-0002-0327-5224
정재호(Cheong, Jae Ho)
최윤영(Choi, Yoon Young) ORCID logo https://orcid.org/0000-0002-2179-7851
형우진(Hyung, Woo Jin) ORCID logo https://orcid.org/0000-0002-8593-9214
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