Retrospective Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2019; 7(18): 2712-2721
Published online Sep 26, 2019. doi: 10.12998/wjcc.v7.i18.2712
Prognostic significance of 14v-lymph node dissection to D2 dissection for lower-third gastric cancer
Chen Zheng, Zi-Ming Gao, An-Qi Sun, Hai-Bo Huang, Zhen-Ning Wang, Kai Li, Shan Gao
Chen Zheng, Zi-Ming Gao, An-Qi Sun, Hai-Bo Huang, Zhen-Ning Wang, Kai Li, Department of Surgical Oncology, First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
Shan Gao, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
Author contributions: Zheng C and Gao S designed research; Gao ZM, Sun AQ and Wang ZN treated patients and collected material and clinical data from patients; Zheng C and Huang HB performed the assays; Zheng C and Gao S analysed data; Zheng C and Li K wrote the paper.
Supported by Foundation for Innovative Talents in Higher Education of Liaoning Province, No. LR2016043.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of First Affiliated Hospital of China Medical University.
Informed consent statement: Written informed consent were obtained from each patient.
Conflict-of-interest statement: All authors declare no conflicts of interest.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement, and the manuscript was prepared and revised according to the STROBE Statement.
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: Shan Gao, MD, Doctor, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, No.36, Sanhao Street, Heping District, Shenyang 110004, Liaoning Province, China. mount1121@hotmail.com
Telephone: +86-18940259333
Received: June 13, 2019
Peer-review started: June 18, 2019
First decision: July 30, 2019
Revised: August 6, 2019
Accepted: August 20, 2019
Article in press: August 20, 2019
Published online: September 26, 2019
Processing time: 104 Days and 4.3 Hours
ARTICLE HIGHLIGHTS
Research background

In the fifteenth edition of the Japanese Classification of Gastric Carcinoma, the 14v lymph node (LN) (LNs along the root of the superior mesenteric vein) was defined as the regional gastric LN.

Research motivation

The efficacy of 14v LN dissection during radical distal gastrectomy for lower-third gastric cancer (GC) remains controversial.

Research objectives

To analyze whether the addition of 14v LN dissection improved the survival of patients with lower-third GC.

Research methods

Using the propensity score-matched method from our institute database constructed between 2000 and 2012, overall survival (OS) was compared between the patients with and without 14v LN dissection.

Research results

OS was similar between patients with 14v LN metastasis and those with distant metastasis. Among patients with pathological stage IIIA disease, those who were treated with 14v LN dissection had a significantly higher OS than those treated without it.

Research conclusions

Adding 14v LN dissection to D2 dissection during radical distal gastrectomy may improve the OS of patients with pathological stage IIIA lower-third GC.

Research perspectives

In the future, high-quality multicenter clinical randomized controlled studies are needed to evaluate the effect of 14v LN dissection on OS.