title: Positive impact of adding No.14v lymph node to D2 dissection on survival for distal gastric cancer patients after surgery with curative intent.
abstract: BACKGROUND
  D2 lymphadenectomy has been increasingly regarded as standard surgical procedure for advanced gastric cancer (GC), while the necessity of No.14v lymph node (14v) dissection for distal GC is still controversial.
  
  
  METHODS
  A total of 920 distal GC patients receiving at least a D2 lymph node dissection in Department of Gastric Cancer, Tianjin Medical University Cancer Institute and Hospital were enrolled in this study, of whom, 243 patients also had the 14v dissected. Other 677 patients without 14v dissection were used for comparison.
  
  
  RESULTS
  Forty-five (18.5%) patients had 14v metastasis. There was no significant difference in 3-year overall survival (OS) rate between patients with and without 14v dissection. Following stratified analysis, in TNM stages I, II, IIIa and IV, 14v dissection did not affect 3-year OS; in contrast, patients with 14v dissection had a significant higher 3-year OS than those without in TNM stages IIIb and IIIc. In multivariate analysis, 14v dissection was found to be an independent prognostic factor for GC patients with TNM stage IIIb/IIIc disease [hazard ratio (HR), 1.568; 95% confidence interval (CI): 1.186-2.072; P=0.002]. GC patients with 14v dissection had a significant lower locoregional, especially lymph node, recurrence rate than those without 14v dissection (11.7% vs. 21.1%, P=0.035).
  
  
  CONCLUSIONS
  Adding 14v to D2 lymphadenectomy may be associated with improved 3-year OS for distal GC staged TNM IIIb/IIIc.
authors.affiliation: 1 Department of Gastric Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China ; 2 Department of Abdominal Cancer, Hainan Province Cancer Hospital, Haikou 570100, China.
authors.forename: Yuexiang
authors.initials: Y
authors.lastname: Liang
authors.affiliation: 1 Department of Gastric Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China ; 2 Department of Abdominal Cancer, Hainan Province Cancer Hospital, Haikou 570100, China.
authors.forename: Liangliang
authors.initials: L
authors.lastname: Wu
authors.affiliation: 1 Department of Gastric Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China ; 2 Department of Abdominal Cancer, Hainan Province Cancer Hospital, Haikou 570100, China.
authors.forename: Xiaona
authors.initials: X
authors.lastname: Wang
authors.affiliation: 1 Department of Gastric Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China ; 2 Department of Abdominal Cancer, Hainan Province Cancer Hospital, Haikou 570100, China.
authors.forename: Xuewei
authors.initials: X
authors.lastname: Ding
authors.affiliation: 1 Department of Gastric Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China ; 2 Department of Abdominal Cancer, Hainan Province Cancer Hospital, Haikou 570100, China.
authors.forename: Hongmin
authors.initials: H
authors.lastname: Liu
authors.affiliation: 1 Department of Gastric Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China ; 2 Department of Abdominal Cancer, Hainan Province Cancer Hospital, Haikou 570100, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Li
authors.affiliation: 1 Department of Gastric Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China ; 2 Department of Abdominal Cancer, Hainan Province Cancer Hospital, Haikou 570100, China.
authors.forename: Baogui
authors.initials: B
authors.lastname: Wang
authors.affiliation: 1 Department of Gastric Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China ; 2 Department of Abdominal Cancer, Hainan Province Cancer Hospital, Haikou 570100, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Pan
authors.affiliation: 1 Department of Gastric Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China ; 2 Department of Abdominal Cancer, Hainan Province Cancer Hospital, Haikou 570100, China.
authors.forename: Rupeng
authors.initials: R
authors.lastname: Zhang
authors.affiliation: 1 Department of Gastric Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China ; 2 Department of Abdominal Cancer, Hainan Province Cancer Hospital, Haikou 570100, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Liu
authors.affiliation: 1 Department of Gastric Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China ; 2 Department of Abdominal Cancer, Hainan Province Cancer Hospital, Haikou 570100, China.
authors.forename: Han
authors.initials: H
authors.lastname: Liang
keywords: Gastric carcinoma; No.14v lymph node; dissection; metastasis; prognosis