Prognostic Impact of Extended Lymph Node Dissection versus Limited Lymph Node Dissection on pN0 Proximal Advanced Gastric Cancer: a Propensity Score Matching Analysis
Journal of Gastric Cancer
; : 212-224, 2019.
Article
em En
| WPRIM
| ID: wpr-764485
Biblioteca responsável:
WPRO
ABSTRACT
PURPOSE:
Splenic hilar lymph node dissection (LND) during total gastrectomy is regarded as the standard treatment for proximal advanced gastric cancer (AGC). This study aimed to investigate whether splenic hilar LND or D2 LND is essential for proximal AGC of pT2-4aN0M0 stage. MATERIALS ANDMETHODS:
Data of curative total gastrectomies (n=370) performed from 2000 to 2010 for proximal AGC of pT2-4aN0 stage were retrospectively reviewed. Clinicopathological characteristics and long-term outcomes were compared using propensity score matching between patients who underwent splenectomy (n=43) and those who did not (n=327) and between patients who underwent D2 LND (n=122) and those who underwent D1+ LND (n=248).RESULTS:
Tumors of larger size and a more advanced T stage and significantly lower overall and relapse-free survival (P<0.001) were observed in the splenectomy group than in the 2 spleen-preserving groups. Before propensity score matching, worse overall and relapse-free survival (P<0.001) was observed in the splenectomy group than in the non-splenectomy group. After matching, although the overall survival became similar (P=0.123), relapse-free survival was worse in the splenectomy group (P=0.021). Compared with D1+ LND, D2 LND had no positive impact on the overall (P=0.619) and relapse-free survival (P=0.112) after propensity score matching.CONCLUSIONS:
Splenic hilar LND with or without splenectomy may not have an oncological benefit for patients with pathological AGC with no LN metastasis.Palavras-chave
Texto completo:
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Base de dados:
WPRIM
Assunto principal:
Prognóstico
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Esplenectomia
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Neoplasias Gástricas
/
Estudos Retrospectivos
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Pontuação de Propensão
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Gastrectomia
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Excisão de Linfonodo
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Linfonodos
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Metástase Neoplásica
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Limite:
Humans
Idioma:
En
Revista:
Journal of Gastric Cancer
Ano de publicação:
2019
Tipo de documento:
Article