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Posterior and Para-Aortic (D2plus) Lymphadenectomy after Neoadjuvant/Conversion Therapy for Locally Advanced/Oligometastatic Gastric Cancer.

作者信息

Marrelli Daniele, Piccioni Stefania Angela, Carbone Ludovico, Petrioli Roberto, Costantini Maurizio, Malagnino Valeria, Bagnacci Giulio, Rizzoli Gabriele, Calomino Natale, Piagnerelli Riccardo, Mazzei Maria Antonietta, Roviello Franco

机构信息

Unit of General Surgery and Surgical Oncology, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy.

Unit of Medical Oncology, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy.

出版信息

Cancers (Basel). 2024 Mar 31;16(7):1376. doi: 10.3390/cancers16071376.


DOI:10.3390/cancers16071376
PMID:38611054
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11010857/
Abstract

Super-extended (D2plus) lymphadenectomy after chemotherapy has been reported in only a few studies. This retrospective study evaluates survival outcomes in a Western cohort of locally advanced or oligometastatic gastric cancer patients who underwent D2plus lymphadenectomy after neoadjuvant chemotherapy. A total of 97 patients treated between 2010 and 2022 were included. Of these, 62 had clinical stage II/III disease, and 35 had stage IV disease. Most patients (65%) received preoperative DOC/FLOT chemotherapy. The mean number of lymph nodes harvested was 39. Pathological positive nodes in the posterior/para-aortic stations occurred in 17 (17.5%) patients. Lymphovascular invasion, ypN stage, clinical stage, and perineural invasion were predictive factors for positive posterior/para-aortic nodes. Postoperative complications occurred in 21 patients, whereas severe complications (grade III or more) occurred in 9 cases (9.3%). Mortality rate was 1%. Median overall survival (OS) was 59 months (95% CI: 13-106), with a five-year survival rate of 49 ± 6%; the five-year OS after R0 surgery was 60 ± 7%. In patients with positive posterior/para-aortic nodes, the median OS was 15 months (95% CI: 13-18). D2plus lymphadenectomy after chemotherapy for locally advanced or oligometastatic gastric cancer is feasible and associated with low morbidity/mortality rates. The incidence of pathological metastases in posterior/para-aortic nodes is not negligible even after systemic chemotherapy, with poor long-term survival.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6656/11010857/ffce69dc3214/cancers-16-01376-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6656/11010857/92b7e7888dc2/cancers-16-01376-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6656/11010857/ffce69dc3214/cancers-16-01376-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6656/11010857/92b7e7888dc2/cancers-16-01376-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6656/11010857/ffce69dc3214/cancers-16-01376-g002.jpg

相似文献

[1]
Posterior and Para-Aortic (D2plus) Lymphadenectomy after Neoadjuvant/Conversion Therapy for Locally Advanced/Oligometastatic Gastric Cancer.

Cancers (Basel). 2024-3-31

[2]
Incidence and Prognostic Value of Metastases to "Posterior" and Para-aortic Lymph Nodes in Resectable Gastric Cancer.

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[3]
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[4]
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[5]
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[7]
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[10]
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引用本文的文献

[1]
Outcome of Conversion Surgery After Induction Therapy for Esophageal Cancer with Synchronous Para-Aortic Lymph Node Metastasis: A Multi-institutional Retrospective Study.

Ann Surg Oncol. 2025-8-20

[2]
Survival outcomes in patients with stages I-III gastric adenocarcinoma treated with surgery alone versus surgery plus adjuvant chemotherapy: A systematic review.

J Biol Methods. 2025-4-18

[3]
Heterogeneity of metastatic gastric cancer: solitary non-regional lymph node metastasis and solitary lung metastasis showed better survival outcomes than other metastatic patterns.

BMC Cancer. 2025-8-8

[4]
The Effect of Extended Dissection of Lymph Nodes (D2plus) with Gastrectomy on the Clinical and Oncological Outcomes in Gastric Cancer Patients, Compared to a Standard Dissection (D2).

Medicina (Kaunas). 2025-7-16

[5]
Risk factors as criteria for drain use in gastrectomy: A prospective study.

Mol Clin Oncol. 2025-6-26

[6]
Minimally invasive lymphadenectomy for gastric cancer: Could the robotic approach provide any benefits than laparoscopy?

World J Gastrointest Oncol. 2025-6-15

[7]
A LODDS-based nomogram for overall and cancer-specific survival in stage III-IV gastric signet ring cell carcinoma.

Front Mol Biosci. 2025-5-14

[8]
Proportional Correlation Between Systemic Inflammation Response Index and Gastric Cancer Recurrence Time: A Retrospective Study.

Cancers (Basel). 2025-4-23

[9]
Prospects for the application of pathological response rate in neoadjuvant therapy for gastric cancer.

Front Oncol. 2025-4-11

[10]
Transfusion Thresholds and Risk Factors of Acute Kidney Injury in Gastrointestinal Oncology Surgery: Insights from a Retrospective Study.

Healthcare (Basel). 2025-2-28

本文引用的文献

[1]
Long-term treatment outcomes in gastric cancer with oligometastasis.

Ann Gastroenterol Surg. 2023-8-31

[2]
Short-term outcomes of preoperative chemotherapy with docetaxel, oxaliplatin, and S-1 for gastric cancer with extensive lymph node metastasis (JCOG1704).

Gastric Cancer. 2024-3

[3]
Treatment strategy for successful conversion surgery in clinical stage IVB gastric cancer.

Eur J Surg Oncol. 2024-2

[4]
Extended Lymphadenectomy for Gastric Cancer in the Neoadjuvant Era: Current Status, Clinical Implications and Contentious Issues.

Curr Oncol. 2023-1-8

[5]
Immunohistochemical Markers of the Epithelial-to-Mesenchymal Transition (EMT) Are Related to Extensive Lymph Nodal Spread, Peritoneal Dissemination, and Poor Prognosis in the Microsatellite-Stable Diffuse Histotype of Gastric Cancer.

Cancers (Basel). 2022-12-7

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Gastric Cancer. 2023-1

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Ann Oncol. 2022-10

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Radiother Oncol. 2022-8

[9]
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World J Gastrointest Oncol. 2022-2-15

[10]
International Retrospective Cohort Study of Conversion Therapy for Stage IV Gastric Cancer 1 (CONVO-GC-1).

Ann Gastroenterol Surg. 2021-10-20

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