Department of Surgical Oncology, First Affiliated Hospital of China Medical University, 16th Floor, 4th Building, No. 155, Nanjing North Street, Heping District, Shenyang, Liaoning, People's Republic of China.
Clin Transl Oncol. 2019 Dec;21(12):1699-1706. doi: 10.1007/s12094-019-02103-0. Epub 2019 Apr 11.
Radical gastrectomy with D2 lymphadenectomy has been widely recognized as standard surgical procedure for advanced gastric cancer, while the role of No. 14v lymphadenectomy in distal gastric cancer remains controversial.
Clinicopathological data of 793 distal gastric cancer patients who underwent at least a radical D2 lymphadenectomy with No. 6 nodes metastasis were retrospectively reviewed.
Fifty patients received No. 14v lymphadenectomy. Patients with No. 14v nodes metastasis (21/50, 42.0%) had poor prognosis. The No. 14v nodes metastasis was not an independent prognostic factor (P = 0.075). In distal gastric cancer patients with No. 6 nodes metastasis, No. 14v lymphadenectomy deteriorated overall survival, what's more, No. 14v lymphadenectomy was an independent risk prognostic factor (hazard ratio: 1.404; 95% confidence interval 1.043-1.889; P = 0.025). There was no significant difference in overall or locoregional and other types of recurrence rate between the 14vD+ and the 14vD- groups. The proportion of complication rate was greater in 14vD+ group (P = 0.001).
Extended D2 gastrectomy including No. 14v lymphadenectomy seems to be associated with poor overall survival and increased complication rate of distal gastric cancer patients with No. 6 nodes metastasis.
根治性胃切除术联合 D2 淋巴结清扫术已被广泛认为是治疗进展期胃癌的标准手术方法，而远端胃癌第 14v 淋巴结清扫术的作用仍存在争议。
回顾性分析了 793 例至少接受根治性 D2 淋巴结清扫术且第 6 站淋巴结转移的远端胃癌患者的临床病理资料。
50 例患者接受了第 14v 淋巴结清扫术。有第 14v 淋巴结转移的患者（21/50，42.0%）预后较差。第 14v 淋巴结转移不是独立的预后因素（P=0.075）。在第 6 站淋巴结转移的远端胃癌患者中，第 14v 淋巴结清扫术降低了总生存率，而且第 14v 淋巴结清扫术是独立的风险预后因素（风险比：1.404；95%置信区间 1.043-1.889；P=0.025）。第 14vD+组和第 14vD-组的总复发率、局部复发率和其他类型复发率之间无显著差异。第 14vD+组的并发症发生率更高（P=0.001）。
对于第 6 站淋巴结转移的远端胃癌患者，扩大 D2 胃切除术联合第 14v 淋巴结清扫术似乎与总体生存率降低和并发症发生率增加相关。
