Preoperative Chemotherapy Combined with Para-aortic Lymph Node Dissection Has Clinical Value in the Treatment of Gastric Cancer with Para-aortic Lymph Node Metastases

Overview

Journal BMC Surg

Publisher Biomed Central

Specialty General Surgery

Date 2022 Nov 20

PMID 36404297

Authors

Pengcheng Yu

Can Hu

Yi Wang

Zhehan Bao

Ruolan Zhang

Mengxuan Cao

Yanqiang Zhang

Xiangdong Cheng

Zhiyuan Xu

Affiliations

Soon will be listed here.

Abstract

Background: Lymph node metastases often occur in advanced gastric cancer, with some patients presenting with metastases in the para-aortic lymph nodes. There are persistent Controversies about the benefit of para-aortic lymph node dissection (PAND). Our purpose is to probe whether PAND following preoperative chemotherapy had any clinical significance in individuals with PALNs in gastric cancer.

Material And Methods: To retrospectively analyze the clinical data of 86 gastric cancer patients (40 in the D2 + PAND group and 46 in the D2 group) who attended the abdominal surgery department of Zhejiang Cancer Hospital between September 1, 2008, and July 30, 2018.

Results: In the D2 + PAND group (40 cases), the average number of lymph nodes cleared per case was 4.3 in group 16 (16a2, 16b1), and the postoperative pathology confirmed lymph node positivity in 16 cases, with a metastasis rate of 40%. The median overall survival times were 63 and 34 months for the patients in the D2 + PAND group and D2 group, respectively. The 3-year overall survival (OS) compared to the D2 group (D2 + PAND 69.1% vs. D2 50%, P = 0.012) and a statistically significant difference in 3-year disease-free survival (DFS) (D2 + PAND 69.6% vs. D2 38.3%, P = 0.007). Lymph node dissection extent and recurrence of para-aortic lymph nodes were independent prognostic variables for the patients. The recurrence rate was reduced in the D2 + PAND group compared to the D2 group (D2 + PAND 7.5% vs. D2 26.1%, p = 0.023).

Conclusions: For patients with gastric cancer whose imaging suggests metastasis in the para-aortic lymph nodes, preoperative chemotherapy combined with PAND is an effective and safe treatment that may benefit patient survival.

Citing Articles

Clinicopathological characteristics and treatment outcome of resectable gastric cancer patients with small para-aortic lymph node.

Yao Z, Yang H, Cui M, Xing J, Zhang C, Zhang N Front Oncol. 2023; 13:1131725.

PMID: 36923426 PMC: 10009175. DOI: 10.3389/fonc.2023.1131725.

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