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Updated: Feb 27, 2026
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Published on: February 16, 2024
Prognostic Factors and Recurrence Pattern of Far-advanced Gastric Cancer with Pathologically-positive Para-aortic
Akio Kaito1,2, Takahiro Kinoshita3, Masanori Tokunaga1
1Gastric Surgery Division, National Cancer Center Hospital East, Kashiwa, Japan.
Background:
The role of para-aortic lymph node (PALN) dissection for far-advanced gastric cancer is controversial in patients with clinical PALN positivity who have responded to chemotherapy.
Materials And Methods:
We retrospectively analyzed long-term outcomes of patients with pathologically-positive PALNs who underwent radical gastrectomy.
Results:
The 3- and 5-year overall survival (OS) rates of 65 pathologically PALN-positive patients who underwent PALN dissection (n=704) were 33.8% and 21.2%, respectively. Multivariable analysis revealed the following poor prognostic factors: nodal involvement around the celiac axis (hazard ratio (HR)=4.04, 95% confidence interval (CI)=1.55-9.63), tumor diameter of ≥120 mm (HR=3.37; 95% CI=1.18-9.63) and ≥3 PALNs involved (HR=2.24; 95% CI=1.21-4.15). Patients with none of these factors survived significantly longer than those with any of these factors (5-year OS=87.5% versus 9.3%, respectively; p<0.001).
Conclusion:
Pathologically PALN-positive patients achieve long survival; however, the indications for PALN dissection should be carefully considered.
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