The correlation between No. 6 and No. 14v lymph node metastasis and the value of dissecting these lymph nodes in radical gastrectomy.
10.3760/cma.j.cn441530-20221123-00491
- Author:
Q C YANG
1
;
H K ZHOU
1
;
C YUE
1
;
W D WANG
1
;
R Q GAO
1
;
Z C MO
1
;
P P JI
1
;
J P WEI
1
;
X S YANG
1
;
P F YU
1
;
X H LI
1
;
G JI
1
Author Information
1. Gastrointestinal Surgery Department, the First Affiliated Hospital of Air Force Military Medical University, Xi'an 710032, China.
- Publication Type:Journal Article
- MeSH:
Humans;
Stomach Neoplasms/pathology*;
Lymphatic Metastasis/pathology*;
Prospective Studies;
Retrospective Studies;
Lymph Nodes/pathology*;
Lymph Node Excision;
Gastrectomy;
Multicenter Studies as Topic
- From:
Chinese Journal of Gastrointestinal Surgery
2023;26(1):38-43
- CountryChina
- Language:Chinese
-
Abstract:
Radical gastrectomy with D2 lymphadenectomy has been widely performed as the standard surgery for patients with gastric cancer in major medical centers in China and abroad. However, the exact extent of lymph node dissection is still controversial. In the latest version of the Japanese Gastric Cancer Treatment Guidelines, No. 14v lymph nodes (along the root of the superior mesenteric vein) are again defined as loco-regional lymph nodes, and it is clarified that distal gastric cancer presenting with infra-pyloric regional lymph node (No.6) metastasis is recommended for D2+ superior mesenteric vein (No. 14v) lymph node dissection. To explore the relevance and clinical significance of No.6 and No.14v lymphadenectomy in radical gastric cancer surgery, a review of the national and international literature revealed that No.6 lymph node metastasis was associated with No.14v lymph node metastasis, that No.6 lymph node status was a valid predictor of No.14v lymph node negative status and false negative rate, and that for gastric cancer patients with No. 14v lymph node negative and No.6 lymph node positive, the dissection of No.14v lymph node may also have some significance. The addition of No. 14v lymph node dissection in radical gastrectomy is safe, but it is more important to distinguish the patients who can benefit from it. Professor Liang Han of Tianjin Medical University Cancer Hospital is currently leading a multicenter, large-sample, prospective clinical trial (NCT02272894) in China, which is expected to provide higher level evidence for the clinical significance of lymph node dissection in No.14v.
