Impact of splenic hilar lymph node metastasis on prognosis in patients with advanced gastric cancer

Taeil Son, In Gyu Kwon, Joong Ho Lee, Youn Young Choi, Hyoung Il Kim, Jae Ho Cheong, Sung Hoon Noh, Woo Jin Hyung

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9 Citations (Scopus)


Background: Impact of splenic hilar LN dissection during total gastrectomy for proximal advanced gastric cancer is controversial. The objective of this study was to assess the impact on prognosis of splenic hilar lymph node(LN) metastasis compared to that of metastasis to other regional LN groups. Study Design: Patients who underwent total gastrectomy with D2 LN dissection from 2000 to 2010 were reviewed retrospectively. The clinicopathologic characteristics and long-term results of patients with splenic hilar LN metastasis were compared to those of patients with only metastasis to other extraperigastric LNs (stations #8a, #9, #11, or #12a). To investigate the survival benefit of performing splenic hilar LN dissection, the estimated therapeutic index for the procedure was calculated by multiplying the incidence of metastases in the hilar region by the survival rates for individuals with nodal involvement in that region. Results: Of 602 patients, 87(14.5%) had hilar LN metastasis. The 5-year overall and relapse-free survival rates for patients with hilar LN metastasis were 24.1% and 12.1%, respectively. These rates were similar to those for patients with metastasis to other extraperigastric LNs (P > 0.05), with similar recurrence patterns. Overall survival in the hilar LN metastasis group was better than that for patients with distant metastasis(P < 0.05). The estimated therapeutic index of splenic hilar LN dissection was 3.5, which was similar to index values for LN dissection at other extraperigastric LNs. Conclusions: Dissection of splenic hilar LNs during total gastrectomy for advanced gastric cancer allows for a prognosis similar to that achieved with dissection of extraperigastric LNs.

Original languageEnglish
Pages (from-to)84515-84528
Number of pages14
Issue number48
Publication statusPublished - 2017

Bibliographical note

Funding Information:
All authors have completed the disclosure declaration, and none of the authors or their immediate family members report a conflicting financial interest. This study was supported by a grant from the National R&D Program for Cancer Control, Ministry of Health & Welfare, Republic of Korea (1320270).

Publisher Copyright:
© Son et al.

All Science Journal Classification (ASJC) codes

  • Oncology


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