Abstract
Background: The Japanese Classification of Gastric Carcinoma includes the left gastric artery (#7) lymph nodes (LNs) in the recommended extent of D1 LN dissection, but this recommendation has not been validated in western institutions. Methods: We reviewed data from a prospectively maintained database of gastric cancer patients who underwent resection at our academic cancer center and had a separate pathologic assessment of #7 LN in 2005–2016. Risk factors for #7 LN metastases and overall survival were examined by uni- and multivariable analyses. Results: We identified 173 patients; 114 (66%) were treated with preoperative therapy, most commonly with chemoradiation therapy (47%, 81/173). We identified 22 patients (13%) who had #7 LN metastases, which accounted for 35% (22/63) of node-positive patients. No preoperative factors were associated with #7 LN metastases by univariable analyses. Patients with #7 metastases were not associated with shorter overall survival after adjustment by nodal stage (hazard ratio 1.49, 95% confidence interval 0.67–3.32; p = 0.33). Conclusion: Metastasis to #7 LN station was common in gastric cancer, but the survival impact was not significant after adjustment by nodal stage. We conclude that #7 LNs should be routinely dissected in gastric cancer patients, and this station should be included within the extent of D1 LN dissection.
Original language | English (US) |
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Pages (from-to) | 1563-1570 |
Number of pages | 8 |
Journal | Journal of Gastrointestinal Surgery |
Volume | 21 |
Issue number | 10 |
DOIs | |
State | Published - Oct 1 2017 |
Keywords
- D1 lymph node dissection
- Gastric cancer
- Left gastric artery
- Lymph nodes
- Station
ASJC Scopus subject areas
- Surgery
- Gastroenterology
MD Anderson CCSG core facilities
- Biostatistics Resource Group