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Surgical Endoscopy

, Volume 32, Issue 3, pp 1495–1505 | Cite as

Safety and prognostic impact of prophylactic laparoscopic superior mesenteric vein (No. 14v) lymph node dissection for lower-third gastric cancer: a propensity score-matched case–control study

  • Qi-Yue Chen
  • Chao-Hui Zheng
  • Ping Li
  • Jian-Wei Xie
  • Jia-Bin Wang
  • Jian-Xian Lin
  • Jun Lu
  • Long-Long Cao
  • Mi Lin
  • Ru-Hong Tu
  • Ze-Ning Huang
  • Ju-Li Lin
  • Chang-Ming Huang
Article
  • 147 Downloads

Abstract

Aim

To investigate oncologic efficacy of prophylactic laparoscopic superior mesenteric vein (No. 14v) lymph node (LN) dissection for lower-third gastric cancer (LTGC).

Methods

We retrospectively collected data from 757 patients who underwent laparoscopic-assisted distal gastrectomy for LTGC. Of these patients, 102 underwent 14v LN dissection (14vD+ group), and the remaining 655 patients did not undergo 14v LN dissection (14vD− group). The outcomes were compared using a 1:1 propensity score matching method.

Results

After matching, 93 patients from the 14vD+ group and 93 patients from the 14vD− group with similar clinicopathological characteristics were compared. Before matching, the overall survival (OS) was similar between the two groups (P = 0.742). After matching, the OS was greater in the 14vD+ group (P = 0.025). The status of 14v dissection was not a significant prognostic factor in the survival analyses, both before and after matching. However, a stratified analysis according to the independent factors in the OS showed that the OS in the 14vD+ group was higher than that in the 14vD− group for cT2-3 patients after matching. The forest plot of OS showed that after matching the 14vD+ group had a significantly higher 3-year OS rate than the 14vD− group in cT2-3 patients. The distribution of the therapeutic index demonstrated that the index of 14v LN was similar to those of Nos. 1, 7, 8a, 9, and 11p after matching.

Conclusions

Adding laparoscopic 14v dissection for laparoscopic-assisted radical distal gastrectomy was safe and might improve the OS for clinically advanced LTGC without serosal invasion.

Keywords

Gastric carcinoma No. 14v lymph node Lymphadenectomy Prognosis Propensity score matching 

Notes

Acknowledgements

This study is supported by National Key Clinical Specialty Discipline Construction program of China (No. [2012]649), and Scientific and technological innovation joint capital projects of Fujian Province (2016Y9031).

Compliance with ethical standards

Disclosures

Qi-Yue Chen, Chao-Hui Zheng, Ping Li, Jian-Wei Xie, Jia-Bin Wang, Jian-Xian Lin, Jun Lu, Long-Long Cao, Mi Lin, Ru-Hong Tu, Ze-Ning Huang, Ju-Li Lin and Chang-Ming Huang have no conflicts of interest or financial ties to disclose.

Supplementary material

464_2017_5837_MOESM1_ESM.docx (22 kb)
Supplementary Table.1 (DOCX 21 kb)

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Qi-Yue Chen
    • 1
    • 2
    • 3
    • 4
  • Chao-Hui Zheng
    • 1
    • 2
    • 3
    • 4
  • Ping Li
    • 1
    • 2
    • 3
    • 4
  • Jian-Wei Xie
    • 1
    • 2
    • 3
    • 4
  • Jia-Bin Wang
    • 1
    • 2
    • 3
    • 4
  • Jian-Xian Lin
    • 1
    • 2
    • 3
    • 4
  • Jun Lu
    • 1
    • 2
    • 3
    • 4
  • Long-Long Cao
    • 1
    • 2
    • 3
    • 4
  • Mi Lin
    • 1
    • 2
    • 3
    • 4
  • Ru-Hong Tu
    • 1
    • 2
    • 3
    • 4
  • Ze-Ning Huang
    • 1
    • 2
    • 3
    • 4
  • Ju-Li Lin
    • 1
    • 2
    • 3
    • 4
  • Chang-Ming Huang
    • 1
    • 2
    • 3
    • 4
  1. 1.Department of Gastric SurgeryFujian Medical University Union HospitalFuzhouChina
  2. 2.Department of General SurgeryFujian Medical University Union HospitalFuzhouChina
  3. 3.Key Laboratory of Ministry of Education of Gastrointestinal CancerFujian Medical UniversityFuzhouChina
  4. 4.Fujian Key Laboratory of Tumor MicrobiologyFujian Medical UniversityFuzhouChina

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