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Background:D2 lymphadenectomy has been increasingly regarded as standard surgical procedure for advanced gastric cancer(GC),while the necessity of No.14 v 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 14 v dissected.Other 677 patients without 14 v dissection were used for comparison.Results:Forty-five(18.5%) patients had 14 v metastasis.There was no significant difference in 3-year overall survival(OS) rate between patients with and without 14 v dissection.Following stratified analysis,in TNM stages I,II,IIIa and IV,14 v dissection did not affect 3-year OS;in contrast,patients with 14 v dissection had a significant higher 3-year OS than those without in TNM stages IIIb and IIIc.In multivariate analysis,14 v 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 14 v dissection had a significant lower locoregional,especially lymph node,recurrence rate than those without 14 v dissection(11.7 % vs.21.1%,P=0.035).Conclusions:Adding 14 v to D2 lymphadenectomy may be associated with improved 3-year OS for distal GC staged TNM Ⅲb/Ⅲc.
Background: D2 lymphadenectomy has been considered as a standard surgical procedure for advanced gastric cancer (GC), while the necessity of No. 14 v 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 14 v dissected. Of 677 patients without 14 v dissection were used for comparison Results: Forty-five (18.5%) patients had 14 significant changes in 3-year overall survival (OS) between patients with and without 14 v dissection. Popular 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. 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 14 v dissection had a significant lower locoregional, especially lymph node, recurrence rate than those without 14 v dissection (11.7% vs. 21.1%, P = 0.035) .Conclusions: Adding 14 v to D2 lymphadenectomy may be associated with improved 3-year OS for distal GC staged TNM IIIb / Ⅲc.