Risk factors for No. 12p and No. 12b lymph node metastases in advanced gastric cancer in China

Feng, J.; Huang, Ying; Liu, Jing; Liu, Huang; Sheng, Huaying; Wei, Wei‐Tian; Lu, Weishan; Chen, Da-Feng; Chen, Wen-You; Xiao-fang, Zhou

doi:10.3109/03009734.2012.729103

Cited by 8 publications

(16 citation statements)

References 28 publications

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“…12 lymph node metastasis in lower 1/3 GC (6.8%) was higher than that in middle (2.6%) and upper (2.7%) 1/3 GC. A study by Feng et al [15] also confirmed the same results, reporting 7.7% as the rate of No. 12b lymph node metastasis and 15.4% as the rate of No.…”

Section: Discussionsupporting

confidence: 56%

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Evaluation of D2-plus radical resection for gastric cancer with pyloric invasion

Chen

et al. 2019

BMC Surg

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Background: The optimal lymphadenectomy for gastric cancer (GC) with pyloric invasion is controversial because the pattern of lymph node metastasis is different from that of distal GC. The rate of lymph node metastasis into the posterior area of the pancreatic head and hepatoduodenal ligament is high. This study evaluated the estimated benefit of radical gastrectomy with D2-plus lymphadenectomy in patients with pyloric invasion. Methods: All patients with GC invading the pylorus who underwent curative surgical resection with D2-plus lymphadenectomy between February 2013 and September 2015 were enrolled in the study. The index of estimated benefit from lymph node dissection (IEBLD) was calculated by multiplying the incidence of metastasis to each lymph node station by the 3-year overall survival (OS) rate of patients with metastasis to that station. Results: In total, 128 patients were eligible. The rate of lymph node metastasis and the 3-year OS rate (and IEBLD) of the patients with metastasis to lymph nodes were 14.3 and 44.4% (5.56) for No. 8p, 10.9 and 35.7% (3.89) for No. 12b, 9.5 and 33.3% (3.13) for No. 12p, 18.8 and 54.2% (10.19) for No. 13, and 21.8 and 53.6% (11.68) for No. 14v, respectively. Conclusions: In radical gastrectomy for GC with pyloric invasion, some survival benefit was observed with dissection of the No. 13 and No. 14 lymph nodes, but there was no survival benefit with dissection of the No. 8p lymph nodes. The No. 12b and No. 12p lymph nodes may be better to dissect in cT3 GC patients with pyloric invasion.

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Section: Discussionsupporting

confidence: 56%

“…12b and No. 12p lymph node metastasis is not an independent prognostic factor [16]. Furthermore, dissection of the No.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of D2-plus radical resection for gastric cancer with pyloric invasion

Chen

et al. 2019

BMC Surg

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“…Feng et al . 5 revealed that the metastatic rates of 12p and 12b were 9.2% and 3.1%, respectively, and GC patients with 12b and 12p metastases had a significant lesser OS rate than those without (13.3% versus 35.1%, P = 0.022). However, Kumagai et al .…”

Section: Discussionmentioning

confidence: 97%

“…Previous study had focused on a single LN station and negated the value of LNs dissection because of its lower metastatic rate and poorer survival 4,5,15 . An et al .…”

Section: Discussionmentioning

confidence: 99%

“D2 plus” lymphadenectomy is associated with improved survival in distal gastric cancer with clinical serosa invasion: a propensity score analysis

Liang

Cui

Cai

et al. 2019

Sci Rep

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The aim of this study was to elucidate the potential impact of “D2 plus” lymphadenectomy on the long-term survival of distal gastric cancer (GC) patients with clinical serosa invasion. A total of 394 distal GC patients with clinical serosa invasion who underwent at least standard D2 lymphadenectomy were enrolled. Patients were categorized into two groups according to the extent of lymphadenectomy: D2 group and “D2 plus” group. Propensity score matching was used to adjust for the differences in baseline characteristics. In the multivariate analysis for the whole study series, extent of lymphadenectomy was an independent prognostic factor for GC patients (P = 0.011). With the strata analysis, the significant prognostic differences between the two groups were only observed in patients at the IIIa-b or N1-3a stages. After matching, patients in “D2 plus” group still demonstrated a significantly higher 5-year overall survival rate than those in D2 group (55.3% versus 43.9%, P = 0.042). The common therapeutic value index of No. 12b, No. 12p, No. 14v and No. 13 LNs was 4.6, which was close to that of No. 5 LN station. In conclusion, “D2 plus” lymphadenectomy may be associated with improved overall survival in distal GC with clinical serosa invasion.

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“…During investigation of LN involvement of the hepato duodenal ligament (HDLN) a logistic regression analysis showed that no.5 and no.12a LN metastases were associated with a 6.9 and 11.3 fold increase respec tively, for risk of no.12p and no.12b LN metastases. In addition, significant differences in 5-year OS of patients with and without no.12p and no.12b LN metastases were observed [55] . However, the clinical significance of removing these LN was not evaluated.…”

Section: Middle and Distal Gastric Cancermentioning

confidence: 94%

Clinical significance of lymphadenectomy in patients with gastric cancer

Tóth

Plósz

Török

2016

WJGO

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Approximately thirty percent of patients with gastric cancer undergo an avoidable lymph node dissection with a higher rate of postoperative complication. Comparing the D1 and D2 dissections, it was found that there is a significant difference in morbidity, favoured D1 dissection without any difference in overall survival. Subgroup analysis of patients with T3 tumor shows a survival difference favoring D2 lymphadenectomy, and there is a better gastric cancer-related death and non-statistically significant improvement of survival for node-positive disease in patients with D2 dissection. However, the extended lymphadenectomy could improve stage-specific survival owing to the stage migration phenomenon. The deployment of centralization and application of national guidelines could improve the surgical outcomes. The Japanese and European guidelines enclose the D2 lymphadenectomy as the gold standard in R0 resection. In the individualized, stageadapted gastric cancer surgery the Maruyama computer program (MCP) can estimate lymph node involvement preoperatively with high accuracy and in addition the Maruyama Index less than 5 has a better impact on survival, than D-level guided surgery. For these reasons, the preoperative application of MCP is recommended routinely, with an aim to perform "low Maruyama Index surgery". The sentinel lymph node biopsy (SNB) may decrease the number of redundant lymphadenectomy intraoperatively with a high detection rate (93.7%) and an accuracy of 92%. More accurate stage-adapted surgery could be performed using the MCP and SNB in parallel fashion in gastric cancer.

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Risk factors for No. 12p and No. 12b lymph node metastases in advanced gastric cancer in China

Cited by 8 publications

References 28 publications

Evaluation of D2-plus radical resection for gastric cancer with pyloric invasion

Evaluation of D2-plus radical resection for gastric cancer with pyloric invasion

“D2 plus” lymphadenectomy is associated with improved survival in distal gastric cancer with clinical serosa invasion: a propensity score analysis

Clinical significance of lymphadenectomy in patients with gastric cancer

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