Prognostic Factors for Para-aortic Lymph Node Dissection After Neoadjuvant Chemotherapy for Gastric Cancer
Shunji Endo1, Masakazu Ikenaga2, Terumasa Yamada2
1Department of Surgery, Yao Municipal Hospital, Osaka, Japan shunji.endo@hosp-yao.osaka.jp.
Background/Aim:
The prognosis of gastric cancer with para-aortic or bulky lymph node metastases is poor, but the JCOG 0405 study showed relatively good outcomes of neoadjuvant chemotherapy and gastrectomy with para-aortic lymph node dissection. We investigated the prognostic factors for this treatment.
Patients And Methods:
Twenty patients who underwent gastrectomy and para-aortic lymph node dissection after chemotherapy were enrolled from two institutions. The prognostic factors for overall survival were retrospectively analysed using Cox's proportional hazard models.
Results:
The univariate analyses revealed that ypN (3/0-2, p=0.001), ypM1 (para-aortic LYM) (yes/no, p=0.03), histological response (Grade0-1b/2-3, p=0.02), and adjuvant chemotherapy (no/yes, p=0.02) were significant prognostic factors, whereas multivariate analysis revealed ypN and absence of adjuvant chemotherapy to be independent prognostic factors.
Conclusion:
Posttreatment nodal status may be the best surrogate marker for gastric cancer with gastrectomy and para-aortic lymph node dissection after neoadjuvant chemotherapy. Adjuvant chemotherapy seems to be essential to improve survival.
More Related Videos
06:46Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
10:28Gene Regulation and Targeted Therapy in Gastric Cancer Peritoneal Metastasis: Radiological Findings from Dual Energy CT and PET/CT
Published on: January 22, 2018