| Autor: |
Masashi Nishino, Takaki Yoshikawa, Masahiro Yura, Rei Ogawa, Ryota Sakon, Kenichi Ishizu, Takeyuki Wada, Tsutomu Hayashi, Yukinori Yamagata |
| Jazyk: |
angličtina |
| Rok vydání: |
2024 |
| Předmět: |
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| Zdroj: |
Annals of Gastroenterological Surgery, Vol 8, Iss 3, Pp 413-419 (2024) |
| Druh dokumentu: |
article |
| ISSN: |
2475-0328 |
| DOI: |
10.1002/ags3.12759 |
| Popis: |
Abstract Background Standard surgery for upper advanced gastric cancer without invasion of the greater curvature (UGC‐GC) is spleen‐preserving D2 total gastrectomy without dissection of the splenic‐hilar nodes (#10). However, some patients with nodal metastasis to #10 survive more than 5 years due to nodal dissection of #10. If nodal metastasis to #10 is predictable based on the positivity of other nodes dissected by the current standard surgery without #10 nodal dissection, physicians may be able to consider #10 dissection. Methods This study retrospectively reviewed data from the National Cancer Center Hospital in Japan between 2000 and 2012. We selected cases that met the following criteria: (1) D2 or more total gastrectomy with splenectomy, (2) UGC‐GC, and (3) histological type is gastric adenocarcinoma. We performed univariate and multivariate analyses concerning lymph node stations associated with #10 metastasis. Results A total of 366 patients were examined. A multivariate analysis revealed that #10 metastasis was associated with positivity of the nodes along the short gastric arteries (#4sa) and distal nodes along the splenic artery (#11d) (#4sa: p = 0.003, #11d: p = 0.016). When either key node was positive, the metastatic rate of #10 was 24.4%, and the therapeutic value index was 13.3. Conclusions #4sa and #11d were key lymph nodes predicting #10 nodal metastasis in UGC‐GC. When these key nodes are positive on computed tomography before surgery or according to a rapid pathological examination during surgery, dissection of #10 should be considered even if upper advanced tumors are not invading the greater curvature. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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