title: Survival prognosis and clinicopathological features of the lymph nodes along the left gastric artery in gastric cancer: implications for D2 lymphadenectomy.
abstract: The Japanese Gastric Cancer Treatment Guidelines (third edition) have assigned No. 7 station left gastric artery lymph nodes (LNs) to the D1 range of lymphatic dissection. We investigated the clinicopathological characteristics, survival impact, and appropriateness of ascribing No. 7 station LNs to D1 lymphadenectomy in gastric cancer. Patients (n=608) undergoing radical resection with No. 7 station LN dissection were recruited between January 1997 and June 2008. They were subdivided into four groups: N0, no LN metastasis; D1, LN without No. 7 station LN metastasis in the D1 lymphadenectomy region; No. 7, No. 7 station LN without LN metastasis in the D2 lymphadenectomy region; and D2, LN without No. 7 station LN metastasis in the D2 lymphadenectomy region. Of these, 17.2% (n=105) were positive for No. 7 LN metastasis, an important, independent prognostic factor associated with poor clinicopathological parameters, advanced tumor stage, and reduced survival. Tumor behavior in the No. 7 group was similar to that in the D2 group, but poorer than in the D1 group in terms of advanced tumor stage, with 5-year survival rates of 34.3%, 25.9% and 54.6%, respectively. Five-year survival rates in the No. 7 group were comparable to those in the D2 group (P>0.05), but significantly lower than in the D1 group (P<0.05). Logistic multivariate regression analysis established No. 3 and 9 station LN metastasis, node classification, and tumor-node-metastasis stage as independent risk factors for No. 7 station LN metastasis. Thus, No. 7 station LNs should be ascribed to D2 lymphadenectomy in gastric cancer.
authors.affiliation: Division of Gastrointestinal Surgery Center, The First Affiliated Hospital, Gastric Cancer Center, Sun Yat-sen University Guangzhou 510080, China.
authors.forename: Jian-Hui
authors.initials: JH
authors.lastname: Chen
authors.affiliation: Division of Gastrointestinal Surgery Center, The First Affiliated Hospital, Gastric Cancer Center, Sun Yat-sen University Guangzhou 510080, China.
authors.forename: Shi-Rong
authors.initials: SR
authors.lastname: Cai
authors.affiliation: Division of Gastrointestinal Surgery Center, The First Affiliated Hospital, Gastric Cancer Center, Sun Yat-sen University Guangzhou 510080, China.
authors.forename: Er-Tao
authors.initials: ET
authors.lastname: Zhai
authors.affiliation: Division of Gastrointestinal Surgery Center, The First Affiliated Hospital, Gastric Cancer Center, Sun Yat-sen University Guangzhou 510080, China.
authors.forename: Si-Le
authors.initials: SL
authors.lastname: Chen
authors.affiliation: Division of Gastrointestinal Surgery Center, The First Affiliated Hospital, Gastric Cancer Center, Sun Yat-sen University Guangzhou 510080, China.
authors.forename: Kai-Ming
authors.initials: KM
authors.lastname: Wu
authors.affiliation: Division of Gastrointestinal Surgery Center, The First Affiliated Hospital, Gastric Cancer Center, Sun Yat-sen University Guangzhou 510080, China.
authors.forename: Wu
authors.initials: W
authors.lastname: Song
authors.affiliation: Division of Gastrointestinal Surgery Center, The First Affiliated Hospital, Gastric Cancer Center, Sun Yat-sen University Guangzhou 510080, China.
authors.forename: Yu-Long
authors.initials: YL
authors.lastname: He
mesh_terms: D016009:Chi-Square Distribution; D005260:Female; D005743:Gastrectomy; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008197:Lymph Node Excision / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D016017:Odds Ratio; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Gastric cancer; clinicopathological features; left gastric artery; lymph nodes; survival
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