Retrospective Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 21, 2019; 25(19): 2338-2353
Published online May 21, 2019. doi: 10.3748/wjg.v25.i19.2338
Role of D2 gastrectomy in gastric cancer with clinical para-aortic lymph node metastasis
Xiao-Hao Zheng, Wen Zhang, Lin Yang, Chun-Xia Du, Ning Li, Gu-Sheng Xing, Yan-Tao Tian, Yi-Bin Xie
Xiao-Hao Zheng, Yan-Tao Tian, Yi-Bin Xie, Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Wen Zhang, Lin Yang, Chun-Xia Du, Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Ning Li, Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Gu-Sheng Xing, Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Author contributions: All authors helped to perform the research; Zheng XH and Xie YB contributed to study conception and design as well as manuscript writing; Zheng XH and Xing GS contributed to data collection; Zheng XH contributed to data analysis; Zheng XH, Zhang W, Yang L, Du CX, Li N, Tian YT, and Xie YB contributed to performing the treatment.
Supported by the CAMS Initiative for Innovative Medicine, No. 2016-I2M-1-007.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of CAMS.
Informed consent statement: The need for informed consent was waived because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors declare no conflicts of interest related to this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Yi-Bin Xie, MD, Professor, Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuannanli, Chaoyang District, Beijing 10021, China. yibinxie_2003@163.com
Telephone: +86-10-8778712
Received: March 14, 2019
Peer-review started: March 14, 2019
First decision: March 27, 2019
Revised: April 17, 2019
Accepted: April 29, 2019
Article in press: April 29, 2019
Published online: May 21, 2019
Processing time: 67 Days and 5.5 Hours
Core Tip

Core tip: The value of surgical resection in gastric cancer with radiologically overt para-aortic lymph node metastasis (PALM) is still not clear. Current controversial issues include the extent of resection (D1, D2, D2 + para-aortic lymph node metastasis dissection, or D3), surgical timing, and identification of optimal surgical candidates. This study confirmed the benefit of D2 gastrectomy after chemotherapy in select patients. Limited PALM at baseline and complete response of PALM after chemotherapy were proposed as criteria for selecting patients who will potentially benefit from D2 gastrectomy, which should be useful for future clinical trials.