Prognostic Impact of Extended Lymph Node Dissection versus Limited Lymph Node Dissection on pN0 Proximal Advanced Gastric Cancer: a Propensity Score Matching Analysis

Sung Hyun Park; Taeil Son; Won Jun Seo; 이중호; Youn Young Choi; Hyoung-Il Kim; Jae-Ho Cheong; Sung Hoon Noh; Woo Jin Hyung

추천

검색

자료유형: 학술저널

저자정보: Sung Hyun Park Taeil Son Won Jun Seo 이중호 Youn Young Choi Hyoung-Il Kim Jae-Ho Cheong Sung Hoon Noh Woo Jin Hyung

저널정보: 대한위암학회 Journal of Gastric Cancer Journal of Gastric Cancer 제19권 제2호

발행연도: 2019.1

수록면: 212 - 224 (13page)

이용수

📌

연구주제

📖

연구배경

🔬

연구방법

🏆

연구결과

초록· 키워드

오류제보하기

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 and Methods: 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.

참고문헌 (24)

참고문헌 신청

Songun I / 2010 / Surgical treatment of gastric cancer: 15-year follow-up results of the randomised nationwide Dutch D1D2 trial / Lancet Oncol 11:439~449

Sano T / 2004 / Gastric cancer surgery: morbidity and mortality results from a prospective randomized controlled trial comparing D2 and extended para-aortic lymphadenectomy--Japan Clinical Oncology Group study 9501 / J Clin Oncol 22:2767~2773

Ferlay J / 2015 / Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012 / Int J Cancer 136:E359~E386

Blot WJ / 1991 / Rising incidence of adenocarcinoma of the esophagus and gastric cardia / JAMA 265:1287~1289

Ikeguchi M / 2004 / Lymph node metastasis at the splenic hilum in proximal gastric cancer / Am Surg 70:645~648

함께 읽어보면 좋을 논문

논문 유사도에 따라 DBpia 가 추천하는 논문입니다. 함께 보면 좋을 연관 논문을 확인해보세요!