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Is it worthy of adding dissection of the superior mesenteric vein lymph node (14v) to standard D2 gastrectomy for distal gastric cancers with No. 6 lymph node metastasis?

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Abstract

Purpose

Radical gastrectomy with D2 lymphadenectomy has been widely recognized as standard surgical procedure for advanced gastric cancer, while the role of No. 14v lymphadenectomy in distal gastric cancer remains controversial.

Methods

Clinicopathological data of 793 distal gastric cancer patients who underwent at least a radical D2 lymphadenectomy with No. 6 nodes metastasis were retrospectively reviewed.

Results

Fifty patients received No. 14v lymphadenectomy. Patients with No. 14v nodes metastasis (21/50, 42.0%) had poor prognosis. The No. 14v nodes metastasis was not an independent prognostic factor (P = 0.075). In distal gastric cancer patients with No. 6 nodes metastasis, No. 14v lymphadenectomy deteriorated overall survival, what’s more, No. 14v lymphadenectomy was an independent risk prognostic factor (hazard ratio: 1.404; 95% confidence interval 1.043–1.889; P = 0.025). There was no significant difference in overall or locoregional and other types of recurrence rate between the 14vD+ and the 14vD− groups. The proportion of complication rate was greater in 14vD+ group (P = 0.001).

Conclusion

Extended D2 gastrectomy including No. 14v lymphadenectomy seems to be associated with poor overall survival and increased complication rate of distal gastric cancer patients with No. 6 nodes metastasis.

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Acknowledgments

First and foremost, I would like to show my deepest gratitude to my supervisors, Dr. Huimian Xu and Dr. Baojun Huang. I cannot finish my manuscript without their enlightening guidance and impressive patience. I won’t withhold my sincere appreciation to all the teachers and classmates in Department of Surgical Oncology of the First Affiliated Hospital of China Medical University, without their encouragement and support this manuscript cannot be completed. Besides, this work was supported by a grant from the National Natural Science Foundation of China (No. 81272716) and the Shenyang Municipal Science and Technology Plan Project (No. 17-231-1-49).

Funding

This work was supported by a grant from the National Natural Science Foundation of China (No. 81272716) and the Shenyang Municipal Science and Technology Plan Project (No. 17-231-1-49).

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Authors and Affiliations

  1. Department of Surgical Oncology, First Affiliated Hospital of China Medical University, 16th Floor, 4th Building, No. 155, Nanjing North Street, Heping District, Shenyang, Liaoning, People’s Republic of China

    J. Zhang, S. Zou, R. Luo, Z. Zhu, Z. Wang, H. Xu & B. Huang

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  1. J. Zhang
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  2. S. Zou
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  3. R. Luo
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  4. Z. Zhu
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  5. Z. Wang
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  6. H. Xu
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  7. B. Huang
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Correspondence to H. Xu or B. Huang.

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Zhang, J., Zou, S., Luo, R. et al. Is it worthy of adding dissection of the superior mesenteric vein lymph node (14v) to standard D2 gastrectomy for distal gastric cancers with No. 6 lymph node metastasis?. Clin Transl Oncol 21, 1699–1706 (2019). https://doi.org/10.1007/s12094-019-02103-0

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