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Prognostic impact of fluorescent lymphography on gastric cancer

Authors
 Sung Hyun Park  ;  Ki-Yoon Kim  ;  Minah Cho  ;  Yoo Min Kim  ;  Hyoung-Il Kim  ;  Woo Jin Hyung 
Citation
 INTERNATIONAL JOURNAL OF SURGERY, Vol.109(10) : 2926-2933, 2023-10 
Journal Title
INTERNATIONAL JOURNAL OF SURGERY
ISSN
 1743-9191 
Issue Date
2023-10
MeSH
Coloring Agents ; Gastrectomy / methods ; Humans ; Lymph Node Excision / methods ; Lymph Nodes / pathology ; Lymphography* / methods ; Neoplasm Recurrence, Local / surgery ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Stomach Neoplasms* / diagnostic imaging ; Stomach Neoplasms* / surgery
Abstract
Background: Fluorescent lymphography-guided lymphadenectomy (FL) for gastric cancer is gaining popularity. However, its impact on prognosis is not known. This study aimed to assess the prognostic impact of FL in gastric cancer patients.

Materials and methods: This study retrospectively analyzed 5678 gastric cancer patients who underwent gastrectomy from 2013 to 2017. The survival was compared between the FLFL group and the conventional lymphadenectomy (non-FL group) using 1:1 propensity score matching after exclusion. Patients in the FL group underwent gastrectomy with systematic lymphadenectomy after endoscopic peritumoral injection of indocyanine green the day before surgery.

Results: After propensity score matching, the FL and non-FL groups each had 1064 patients with similar demographic and clinicopathological characteristics. All matched variables had a standardized mean difference under 0.1. The FL group showed a significantly higher number of retrieved lymph nodes (56.2±20.1) than the non-FL group (46.2±18.2, P <0.001). The FL group also had more stage III patients ( P= 0.044) than the non-FL group. The FL group demonstrated higher overall survival ( P= 0.038) and relapse-free survival ( P= 0.036) in stage III compared with the non-FL group. However, no significant differences in overall and relapse-free survival were observed between the two groups for stages I ( P= 0.420 and P= 0.120, respectively) and II ( P= 0.200 and P= 0.280, respectively).

Conclusion: FL demonstrated a higher survival in stage III gastric cancer patients by the more accurate staging resulting from larger lymph node retrieval. Thus, given its potential to improve prognostication by enhancing staging accuracy, it is recommended as an option to consider the use of FL in clinical practice.
Files in This Item:
T202306586.pdf Download
DOI
10.1097/JS9.0000000000000572
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ki-Yoon(김기윤)
Kim, Yoo Min(김유민)
Kim, Hyoung Il(김형일) ORCID logo https://orcid.org/0000-0002-6134-4523
Park, Sung Hyun(박성현)
Cho, Minah(조민아) ORCID logo https://orcid.org/0000-0003-3011-5813
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/197406
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