scholarly journals Necessity of prophylactic splenic hilum lymph node clearance for middle and upper third gastric cancer: a network meta-analysis

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Gaozan Zheng ◽  
Jinqiang Liu ◽  
Yinghao Guo ◽  
Fei Wang ◽  
Shushang Liu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Meta Analysis ◽  
Splenic Hilum ◽  
Upper Third

scholarly journals Risk factors of lymph node metastasis in the splenic hilum of gastric cancer patients: A meta-analysis

2020 ◽  
Author(s):  
Jun Du ◽  
Yangchao Shen ◽  
Wenwu Yan ◽  
Jinguo Wang
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Tumor Size ◽  
Vascular Invasion ◽  
Meta Analysis ◽  
Diffuse Type ◽  
Splenic Hilum ◽  
Borrmann Type

Abstract BackgroundThe issue of whether or not splenic hilum lymph nodes (SHLN) should be excised in radical gastrectomy with D2 lymph node dissection remains controversial. In this study, we identified the clinicopathological features in patients with gastric cancer that could serve as predictive risk factors of SHLN metastasis. MethodsWe searched Medline, Embase, PubMed and Web of Science databases from inception to May 2020 and consulted the related references. Overall, 15 articles evaluating a total of 4377 patients were included for study. The odds ratios (OR) of each risk factor and corresponding 95% confidence intervals (CI) were determined using Revman 5.3 software.ResultsOur meta-analysis revealed tumor size greater than 5 cm (p < 0.01), tumor localization in the greater curvature (p < 0.01), diffuse type (Lauren’s classification) (p < 0.01), Borrmann type 3–4 (p < 0.01), poor differentiation and undifferentiation (p < 0.01), depth of invasion T3–T4 (p < 0.01), number of lymph node metastases N2–N3 (p < 0.01), distant metastasis M1 (p < 0.01), TNM stage 3–4 (p < 0.01), vascular invasion (p = 0.01), and lymphatic invasion (p < 0.01) as potential risk factors of SHLN metastasis. Moreover, positivity of Nos. 1, 2, 3, 4sa, 4sb, 4d, 6, 7, 9, 11, and 16 lymph nodes for metastasis was strongly associated with SHLN metastasis.ConclusionsTumor size, tumor location, Lauren’s diffuse type, Borrmann type, degree of differentiation, T stage, N stage, M stage, TNM stage, vascular invasion, lymphatic infiltration, and other positive lymph nodes are risk factors for SHLN metastasis.

scholarly journals Risk factors of lymph node metastasis in the splenic hilum of gastric cancer patients: A meta-analysis

2020 ◽  
Author(s):  
Jun Du ◽  
Yangchao Shen ◽  
Wenwu Yan ◽  
Jinguo Wang
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Tumor Size ◽  
Vascular Invasion ◽  
Meta Analysis ◽  
Splenic Hilum ◽  
Node Metastasis

Abstract Background It remains controversial whether splenic hilum lymph nodes (SHLNs) should be excised in radical gastrectomy with D2 lymph node dissection. In this study, we evaluated the role of clinicopathological features in patients with gastric cancer in predicting splenic hilum lymph nodes metastasis.Methods We searched the Medline, Embase, PubMed and Web of Science databases from inception to May 2020 and consulted related references. 15 articles with a total of 4377 patients were included finally. The odds ratios (ORs) of each risk factor and the corresponding 95% confidence interval (CI) were determined using Revman 5.3 software. Results Meta-analysis showed that tumor size greater than 5 cm (p < 0.01), tumor localization in the greater curvature (p < 0.01), diffuse type (Lauren’s type) (p < 0.01), Borrman type 3–4 (p < 0.01), poor differentiation and undifferentiation (p < 0.01), depth of invasion T3–T4 (p < 0.01), number of lymph node metastases N2–N3 (p < 0.01), distance metastasis M1 (p < 0.01), TNM stage 3–4 (p < 0.01), vascular invasion (p = 0.01), and lymphatic invasion (p < 0.01) were risk factors of SHLNs metastasis. Moreover, No. 1-, 2-, 3-, 4sa-, 4sb-, 4d-, 6-, 7-, 9-, 11-, and 16-positive lymph node metastasis are strongly associated with splenic hilum lymph nodes metastasis.Conclusions Tumor size, tumor location, Lauren’s type, Borrman type, degree of differentiation, T stage, N stage, M stage, TNM stage, vascular invasion, lymphatic infiltration, and other positive lymph nodes metastasis were risk factors for SHLNs.

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

2010 ◽  
Vol 2 (2) ◽  
pp. 81 ◽  
Author(s):  
Keishiro Aoyagi ◽  
Kikuo Kouhuji ◽  
Motoshi Miyagi ◽  
Takuya Imaizumi ◽  
Junya Kizaki ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Total Gastrectomy ◽  
Splenic Hilum

scholarly journals Comparison of laparoscopic versus open gastrectomy with D2 lymph node dissection for advanced gastric cancer: A meta-analysis

2019 ◽  
Vol 1 (2) ◽  
pp. 110-121
Author(s):  
Sandrie Mariella Mac ◽  
Ashish Bahadur Malla
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Advanced Gastric Cancer ◽  
Lymph Node Dissection ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Open Gastrectomy ◽  
Long Term Results ◽  
Node Dissection ◽  
D2 Lymph Node Dissection

For many decades, D2 procedure has been accepted in the far-east as the standard treatment for both early (EGC) and advanced gastric cancer (AGC). In case of AGC, the debate on the extent of nodal dissection has been open for many years in order to highlight the safety and efficacy of treatment, hence this study. A comprehensive literature research was performed in PubMed to identify studies that compared laparoscopic- assisted gastrectomy (LAG) and open gastrectomy (OG) with D2 lymph node dissection (D2-LND) for treatment of AGC for the last five years. Data of interest were checked and subjected to meta-analysis with RevMan 5.3 software. The pooled risk ratios (RR) and weighted mean difference (WMD) with 95% confidence intervals (CI) were calculated. Overall, 19 studies were included in this meta-analysis. LG had some advantages over OG, including shorter hospitalization (WMD -2.31; 95% CI -4.09 to -0.53; P = 0.01), less blood loss (WMD -120.49; 95% CI -174.27 to -66.71; P < 0.01), faster bowel recovery (WMD -0.55; 95% CI -0.86 to -0.24; P ˂ 0.01) and earlier ambulation (WMD -0.75; 95% CI -1.38 to -0.11; P = 0.02). In terms of surgical and oncological safety, LG could achieve similar lymph nodes (WMD, -0.94, 95% CI, -2.95 to 1.06; P=0.36), a lower complication rate [odds ratio (OR)=0.80; 95%CI, 0.68-0.97; P=0.02], and overall survival (OS) and disease-free survival (DFS) comparable to OG. In conclusion, for AGCs both techniques (LAG and OG) appeared comparable in short- and long-term results. More time was needed to perform LAG; nonetheless, it had some advantages in achieving faster postoperative recovery over OG. In order to clarify this controversial issue ongoing trials and future studies are needed.

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