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Limited Clinical Significance of Splenectomy and Splenic Hilar Lymph Node Dissection for Type 4 Gastric Cancer
Type 4 gastric cancer (GC) has a very poor prognosis even after curative resection, and the survival benefit of splenectomy for splenic hilar lymph node (LN; #10) dissection in type 4 GC remains equivocal. This study aimed to clarify the clinical significance of splenectomy for #10 dissection in pat...
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Published in: | Journal of gastric cancer 2021, 21(4), , pp.392-402 |
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container_title | Journal of gastric cancer |
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creator | Kunitomo, Aina Misawa, Kazunari Ito, Yuichi Ito, Seiji Higaki, Eiji Natsume, Seiji Kinoshita, Takashi Abe, Tetsuya Komori, Koji Shimizu, Yasuhiro |
description | Type 4 gastric cancer (GC) has a very poor prognosis even after curative resection, and the survival benefit of splenectomy for splenic hilar lymph node (LN; #10) dissection in type 4 GC remains equivocal. This study aimed to clarify the clinical significance of splenectomy for #10 dissection in patients with type 4 GC.
The data of a total of 56 patients with type 4 GC who underwent total gastrectomy with splenectomy were retrospectively analyzed. Postoperative morbidity, state of LN metastasis, survival outcomes, and therapeutic value index (TVI) of each LN station were evaluated. TVI was calculated by multiplying the incidence of LN metastasis at each nodal station and the 5-year overall survival (OS) of patients who had metastasis to each node.
Overall, the postoperative morbidity rate was 28.6%, and the incidence of #10 metastasis in the patients was 28.6%. The 5-year OS rate for all patients was 29.9%, and most patients developed peritoneal recurrence. Moreover, the 5-year OS rates with and without #10 metastasis were 6.7% and 39.1% (median survival time, 20.4 vs. 46.0 months; P=0.006). The TVI of #10 was as low as 1.92.
The clinical significance of splenectomy in the dissection of #10 for type 4 GC is limited and splenectomy for splenic hilar dissection alone should be omitted. |
doi_str_mv | 10.5230/JGC.2021.21.E37 |
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The data of a total of 56 patients with type 4 GC who underwent total gastrectomy with splenectomy were retrospectively analyzed. Postoperative morbidity, state of LN metastasis, survival outcomes, and therapeutic value index (TVI) of each LN station were evaluated. TVI was calculated by multiplying the incidence of LN metastasis at each nodal station and the 5-year overall survival (OS) of patients who had metastasis to each node.
Overall, the postoperative morbidity rate was 28.6%, and the incidence of #10 metastasis in the patients was 28.6%. The 5-year OS rate for all patients was 29.9%, and most patients developed peritoneal recurrence. Moreover, the 5-year OS rates with and without #10 metastasis were 6.7% and 39.1% (median survival time, 20.4 vs. 46.0 months; P=0.006). The TVI of #10 was as low as 1.92.
The clinical significance of splenectomy in the dissection of #10 for type 4 GC is limited and splenectomy for splenic hilar dissection alone should be omitted.</description><identifier>ISSN: 2093-582X</identifier><identifier>EISSN: 2093-5641</identifier><identifier>DOI: 10.5230/JGC.2021.21.E37</identifier><identifier>PMID: 35079441</identifier><language>eng</language><publisher>Korea (South): The Korean Gastric Cancer Association</publisher><subject>Original ; 일반외과학</subject><ispartof>Journal of Gastric Cancer, 2021, 21(4), , pp.392-402</ispartof><rights>Copyright © 2021. Korean Gastric Cancer Association.</rights><rights>Copyright © 2021. Korean Gastric Cancer Association 2021 Korean Gastric Cancer Association</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c427t-ba28bca2b4dfabecb17ab802aec884bab8758fd4b530f64a36851ef13ea245413</citedby><cites>FETCH-LOGICAL-c427t-ba28bca2b4dfabecb17ab802aec884bab8758fd4b530f64a36851ef13ea245413</cites><orcidid>0000-0002-2047-3919 ; 0000-0002-8019-4858</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8753278/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8753278/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35079441$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.kci.go.kr/kciportal/ci/sereArticleSearch/ciSereArtiView.kci?sereArticleSearchBean.artiId=ART002802367$$DAccess content in National Research Foundation of Korea (NRF)$$Hfree_for_read</backlink></links><search><creatorcontrib>Kunitomo, Aina</creatorcontrib><creatorcontrib>Misawa, Kazunari</creatorcontrib><creatorcontrib>Ito, Yuichi</creatorcontrib><creatorcontrib>Ito, Seiji</creatorcontrib><creatorcontrib>Higaki, Eiji</creatorcontrib><creatorcontrib>Natsume, Seiji</creatorcontrib><creatorcontrib>Kinoshita, Takashi</creatorcontrib><creatorcontrib>Abe, Tetsuya</creatorcontrib><creatorcontrib>Komori, Koji</creatorcontrib><creatorcontrib>Shimizu, Yasuhiro</creatorcontrib><title>Limited Clinical Significance of Splenectomy and Splenic Hilar Lymph Node Dissection for Type 4 Gastric Cancer</title><title>Journal of gastric cancer</title><addtitle>J Gastric Cancer</addtitle><description>Type 4 gastric cancer (GC) has a very poor prognosis even after curative resection, and the survival benefit of splenectomy for splenic hilar lymph node (LN; #10) dissection in type 4 GC remains equivocal. This study aimed to clarify the clinical significance of splenectomy for #10 dissection in patients with type 4 GC.
The data of a total of 56 patients with type 4 GC who underwent total gastrectomy with splenectomy were retrospectively analyzed. Postoperative morbidity, state of LN metastasis, survival outcomes, and therapeutic value index (TVI) of each LN station were evaluated. TVI was calculated by multiplying the incidence of LN metastasis at each nodal station and the 5-year overall survival (OS) of patients who had metastasis to each node.
Overall, the postoperative morbidity rate was 28.6%, and the incidence of #10 metastasis in the patients was 28.6%. The 5-year OS rate for all patients was 29.9%, and most patients developed peritoneal recurrence. Moreover, the 5-year OS rates with and without #10 metastasis were 6.7% and 39.1% (median survival time, 20.4 vs. 46.0 months; P=0.006). The TVI of #10 was as low as 1.92.
The clinical significance of splenectomy in the dissection of #10 for type 4 GC is limited and splenectomy for splenic hilar dissection alone should be omitted.</description><subject>Original</subject><subject>일반외과학</subject><issn>2093-582X</issn><issn>2093-5641</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNpVkd1LHDEUxYO0qFif-1by2D7sms_5eCnIaFdlaaFuoW8hk7lZozPJmMwK-98366rYcOGekN89uXAQ-kzJXDJOzm4WzZwRRue5Lnl5gI4ZqflMFoJ-eNUV-3uETlO6J_nIglLCDtERl6SshaDHyC_d4CbocNM774zu8a1be2ez9AZwsPh27MGDmcKwxdp3-7sz-Mr1OuLldhjv8M_QAb5wKWXOBY9tiHi1HQELvNBpihlvdn7xE_podZ_g9KWfoD8_LlfN1Wz5a3HdnC9nRrBymrWaVa3RrBWd1S2Ylpa6rQjTYKpKtFmXsrKdaCUnthCaF5WkYCkHzYQUlJ-gb3tfH616ME4F7Z77OqiHqM5_r65VXdNCsiqz3_fsuGkH6Az4KepejdENOm6fJ_9_8e4u-zypvARn5c7g64tBDI8bSJMaXDLQ99pD2CTFCsbqgtCSZPRsj5oYUopg376hRO1CVfdro3ahqlzAyzzx5f12b_xrhPwfdNCetw</recordid><startdate>20211201</startdate><enddate>20211201</enddate><creator>Kunitomo, Aina</creator><creator>Misawa, Kazunari</creator><creator>Ito, Yuichi</creator><creator>Ito, Seiji</creator><creator>Higaki, Eiji</creator><creator>Natsume, Seiji</creator><creator>Kinoshita, Takashi</creator><creator>Abe, Tetsuya</creator><creator>Komori, Koji</creator><creator>Shimizu, Yasuhiro</creator><general>The Korean Gastric Cancer Association</general><general>대한위암학회</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>ACYCR</scope><orcidid>https://orcid.org/0000-0002-2047-3919</orcidid><orcidid>https://orcid.org/0000-0002-8019-4858</orcidid></search><sort><creationdate>20211201</creationdate><title>Limited Clinical Significance of Splenectomy and Splenic Hilar Lymph Node Dissection for Type 4 Gastric Cancer</title><author>Kunitomo, Aina ; Misawa, Kazunari ; Ito, Yuichi ; Ito, Seiji ; Higaki, Eiji ; Natsume, Seiji ; Kinoshita, Takashi ; Abe, Tetsuya ; Komori, Koji ; Shimizu, Yasuhiro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c427t-ba28bca2b4dfabecb17ab802aec884bab8758fd4b530f64a36851ef13ea245413</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Original</topic><topic>일반외과학</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kunitomo, Aina</creatorcontrib><creatorcontrib>Misawa, Kazunari</creatorcontrib><creatorcontrib>Ito, Yuichi</creatorcontrib><creatorcontrib>Ito, Seiji</creatorcontrib><creatorcontrib>Higaki, Eiji</creatorcontrib><creatorcontrib>Natsume, Seiji</creatorcontrib><creatorcontrib>Kinoshita, Takashi</creatorcontrib><creatorcontrib>Abe, Tetsuya</creatorcontrib><creatorcontrib>Komori, Koji</creatorcontrib><creatorcontrib>Shimizu, Yasuhiro</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Korean Citation Index</collection><jtitle>Journal of gastric cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kunitomo, Aina</au><au>Misawa, Kazunari</au><au>Ito, Yuichi</au><au>Ito, Seiji</au><au>Higaki, Eiji</au><au>Natsume, Seiji</au><au>Kinoshita, Takashi</au><au>Abe, Tetsuya</au><au>Komori, Koji</au><au>Shimizu, Yasuhiro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Limited Clinical Significance of Splenectomy and Splenic Hilar Lymph Node Dissection for Type 4 Gastric Cancer</atitle><jtitle>Journal of gastric cancer</jtitle><addtitle>J Gastric Cancer</addtitle><date>2021-12-01</date><risdate>2021</risdate><volume>21</volume><issue>4</issue><spage>392</spage><epage>402</epage><pages>392-402</pages><issn>2093-582X</issn><eissn>2093-5641</eissn><abstract>Type 4 gastric cancer (GC) has a very poor prognosis even after curative resection, and the survival benefit of splenectomy for splenic hilar lymph node (LN; #10) dissection in type 4 GC remains equivocal. This study aimed to clarify the clinical significance of splenectomy for #10 dissection in patients with type 4 GC.
The data of a total of 56 patients with type 4 GC who underwent total gastrectomy with splenectomy were retrospectively analyzed. Postoperative morbidity, state of LN metastasis, survival outcomes, and therapeutic value index (TVI) of each LN station were evaluated. TVI was calculated by multiplying the incidence of LN metastasis at each nodal station and the 5-year overall survival (OS) of patients who had metastasis to each node.
Overall, the postoperative morbidity rate was 28.6%, and the incidence of #10 metastasis in the patients was 28.6%. The 5-year OS rate for all patients was 29.9%, and most patients developed peritoneal recurrence. Moreover, the 5-year OS rates with and without #10 metastasis were 6.7% and 39.1% (median survival time, 20.4 vs. 46.0 months; P=0.006). The TVI of #10 was as low as 1.92.
The clinical significance of splenectomy in the dissection of #10 for type 4 GC is limited and splenectomy for splenic hilar dissection alone should be omitted.</abstract><cop>Korea (South)</cop><pub>The Korean Gastric Cancer Association</pub><pmid>35079441</pmid><doi>10.5230/JGC.2021.21.E37</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-2047-3919</orcidid><orcidid>https://orcid.org/0000-0002-8019-4858</orcidid><oa>free_for_read</oa></addata></record> |
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title | Limited Clinical Significance of Splenectomy and Splenic Hilar Lymph Node Dissection for Type 4 Gastric Cancer |
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