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Prognosis of metastatic splenic hilum lymph node in patients with gastric cancer after total gastrectomy and splenectomy

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World Journal of Hepatology 2010年第2期2卷 81-86页

作者： Keishiro Aoyagi Kikuo Kouhuji Motoshi Miyagi Takuya Imaizumi Junya Kizaki Kazuo Shirouzu Department ofSurgery Kurume University School of MedicineFukuoka830-0011Japan

AIM:To clarify the significance of combined resection of the spleen to dissect the No.10 lymph node(LN). METHODS:We studied 191 patients who had undergone total gastrectomy with splenectomy,excluding non-curative cases,resection of multiple gastric cancer, and those with remnant stomach *** clinico-pathological factors were evaluated for any independent contributions to No.10 LN metastasis,usingχ 2 test. Significant factors were extracted for further analysis, carried out using a logistic regression ***,lymph node metastasis was evaluated for any independent contribution to No.10 LN metastasis,using the same *** cumulative survival rate was calculated using the Kaplan-Meier *** significance of any difference between the survival curves was determined using the Cox-Mantel test,and any difference was considered significant at the 5%level. RESULTS:From the variables considered to be potentially associated with No.10 LN metastasis,age, depth,invasion of lymph vessel,N factor,the numberof lymph node metastasis,Stage,the number of sites, and location were found to differ significantly between those with metastasis(the Positive Group)and those without(the Negative Group).A logistic regression analysis showed that the localization and Stage were significant parameters for No.10 LN *** was no case located on the lesser curvature in the Posi-tive *** numbers of No.2,No.3,No.4sa,No. 4sb,No.4d,No.7,and No.11 LN metastasis were each found to differ significantly between the Positive Group and the Negative Group.A logistic regression analysis showed that No.4sa,No.4sb,and No.11 LN metastasis were each a significant parameter for No.10 LN *** was no significant difference in survival curves between the Positive Group and the Negative Group. CONCLUSION:splenectomy should be performed to dissect No.10 LN for cases which have No.4sa,No. 4sb or No.11 LN ***,in cases where the tumor is located on th

关键词： Gastric cancer Lymph node metastasis lymphadenectomy,splenectomy Total gastrectomy

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