Re-evaluation of the rational extent of lymphadenectomy for locally advanced gastric cancer
10.3969/j.issn.1000-8179.2016.01.276
- VernacularTitle:局部进展期胃癌合理淋巴结清扫范围再探讨
- Author:
Han LIANG
- Publication Type:Journal Article
- Keywords:
gastric cancer;
lymphadenectomy;
local advance
- From:
Chinese Journal of Clinical Oncology
2016;(1):11-14
- CountryChina
- Language:Chinese
-
Abstract:
On the basis of randomized clinical trials, the extended (D2) lymph node dissection is now recommended as a globally stan-dard procedure for locally advanced gastric cancer. However, the rational extent of lymphadenectomy for locally advanced gastric can-cer has remained a topic of debate in the past decades. The examined lymph node and extra-nodal metastasis are significantly associ-ated with the survival of gastric cancer patients. Furthermore, the role of splenectomy for complete resection of No. 10 nodes has been controversial;however, the randomized trial of JCOG0110 is yet to be completed. Gastric cancer with No. 14 lymph node metas-tasis is defined as M1 stage in the current version of the Japanese classification. We propose that D2+No.14v lymphadenectomy may be an option in a potentially curative gastrectomy for tumors with apparent metastasis to the No. 6 nodes or infiltrate to duodenum. In view of the limitation of low metastatic rate in para-aortic lymph nodes in Japan Clinical Oncology Group (JCOG9501), the clinical benefits of D2+PAND for patients with stage T3 and/or stage N3 disease, both of which are very common in China and many other coun-tries except Japan and Korea, cannot be determined.
