Limited Clinical Significance of Splenectomy and Splenic Hilar Lymph Node Dissection for Type 4 Gastric Cancer

Aina Kunitomo; Kazunari Misawa; Yuichi Ito; Seiji Ito; Eiji Higaki; Seiji Natsume; Takashi Kinoshita; Tetsuya Abe; Koji Komori; Yasuhiro Shimizu

doi:10.5230/jgc.2021.21.e37

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자료유형: 학술저널

저자정보: Aina Kunitomo (Aichi Cancer Center Hospital) Kazunari Misawa (Aichi Cancer Center Hospital) Yuichi Ito (Aichi Cancer Center Hospital) Seiji Ito (Aichi Cancer Center Hospital) Eiji Higaki (Aichi Cancer Center Hospital) Seiji Natsume (Aichi Cancer Center Hospital) Takashi Kinoshita (Aichi Cancer Center Hospital) Tetsuya Abe (Aichi Cancer Center Hospital) Koji Komori (Aichi Cancer Center Hospital) Yasuhiro Shimizu (Aichi Cancer Center Hospital)

저널정보: 대한위암학회 Journal of Gastric Cancer Journal of Gastric Cancer 제21권 제4호

발행연도: 2021.12

수록면: 392 - 402 (11page)

DOI: 10.5230/jgc.2021.21.e37

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Purpose: Type 4 gastric cancer (GC) has a very poor prognosis even after curative resection, and the survival benefit of splenectomy for splenic hilar lymph node (LN; #10) dissection in type 4 GC remains equivocal. This study aimed to clarify the clinical significance of splenectomy for #10 dissection in patients with type 4 GC. Materials and Methods: The data of a total of 56 patients with type 4 GC who underwent total gastrectomy with splenectomy were retrospectively analyzed. Postoperative morbidity, state of LN metastasis, survival outcomes, and therapeutic value index (TVI) of each LN station were evaluated. TVI was calculated by multiplying the incidence of LN metastasis at each nodal station and the 5-year overall survival (OS) of patients who had metastasis to each node. Results: Overall, the postoperative morbidity rate was 28.6%, and the incidence of #10 metastasis in the patients was 28.6%. The 5-year OS rate for all patients was 29.9%, and most patients developed peritoneal recurrence. Moreover, the 5-year OS rates with and without #10 metastasis were 6.7% and 39.1% (median survival time, 20.4 vs. 46.0 months; P=0.006). The TVI of #10 was as low as 1.92. Conclusions: The clinical significance of splenectomy in the dissection of #10 for type 4 GC is limited and splenectomy for splenic hilar dissection alone should be omitted.

#Splenectomy #Stomach neoplasms #Linitis plastica #Lymph node excision

참고문헌 (35)

참고문헌 신청

Japanese Gastric Cancer Association / 2021 / Japanese gastric cancer treatment guidelines 2018 / Gastric Cancer 24:1~21

Okajima K / 1995 / Splenectomy for treatment of gastric cancer : Japanese experience / World J Surg 19:537~540

Songun I / 2010 / Surgical treatment of gastric cancer : 15-year follow-up results of the randomised nationwide Dutch D1D2 trial / Lancet Oncol 11:439~449

Cuschieri A / 1996 / Postoperative morbidity and mortality after D1 and D2 resections for gastric cancer: preliminary results of the MRC randomised controlled surgical trial / Lancet 347:995~999

Ohkura Y / 2017 / Efficacy of prophylactic splenectomy for proximal advanced gastric cancer invading greater curvature / World J Surg Oncol 15:106

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