title: Risk factors for metastasis to para-aortic lymph nodes in gastric cancer: a single institution study in China.
abstract: BACKGROUND
  Para-aortic lymph node (PAN) dissection is performed in some gastric cancer patients with extensive lymph node involvement. However, there is no consensus on selection of patients that will benefit from this high risk dissection. This study was to identify risk factors for PAN metastasis in gastric cancer.
  
  
  METHODS
  A total of 174 patients with gastric cancer who underwent D2 lymphadenectomy plus para-aortic nodal dissection in Tianjin Medical University Cancer Institute and Hospital from January 2001 to December 2010 were enrolled in the study. The association between clinicopathologic factors and para-aortic nodal invasion was analyzed.
  
  
  RESULTS
  Forty-seven patients (27.0%) had PAN metastases. Pathologic N stage was a significant risk factor for PAN metastasis after adjusting for other factors. A significant difference was shown in the proportion of PAN metastases between the N0/N1 group and N2/N3 group (6.2% versus 45.2%, P < 0.001, OR = 12.620). Lymph node station 9 showed a much higher odds ratio with PAN metastases than other routinely retrieved stations.
  
  
  CONCLUSIONS
  N stage and perigastric nodal status were important and independent risk factors for PAN metastasis, which may be useful for identifying patients at high risk of PAN metastasis who could benefit from PAN dissection.
authors.affiliation: Department of Gastric Cancer, Cancer Institute and Hospital of Tianjin Medical University, Tianjin, China.
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.forename: Han
authors.initials: H
authors.lastname: Liang
authors.forename: Xiaona
authors.initials: X
authors.lastname: Wang
authors.forename: Fangxuan
authors.initials: F
authors.lastname: Li
authors.forename: Xuewei
authors.initials: X
authors.lastname: Ding
authors.forename: Jingyu
authors.initials: J
authors.lastname: Deng
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000473:pathology*; D002681:China; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery*; D008207:Lymphatic Metastasis / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery