[Para-aortic lymph node dissection for far-advanced gastric cancer followed by chemotherapy]

We evaluated the safety of preoperative chemotherapy against advanced gastric cancer with para-aortic lymph node metastasis. In this study, we compared 11 patients who received preoperative chemotherapy(PC group) to 56 patients who did not receive preoperative chemotherapy (NPC group). We performed 47 total gastrectomies and 2 distal gastrectomies in the PC group and 9 total gastrectomies and 9 distal gastrectomies in the NPC group. In the PC group, the mean operation time was 275 min for distal gastrectomy and 297 min for total gastrectomy. In the NPC group, the mean operation time was 265 min for distal gastrectomy and 296 min for total gastrectomy. Regarding blood loss during operation, in the PC group, the mean blood loss was 650 mL for distal gastrectomy and 760 mL for total gastrectomy. In the NPC group, the mean blood loss was 530 mL for distal gastrectomy and 825 mL for total gastrectomy. No significant differences were seen between the 2 groups. In conclusion, preoperative chemotherapy against advanced gastric cancer with para-aortic lymph node metastasis appears to be a safe treatment, but we need to conduct clinical trials for confirmation.