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Does Splenic Hilar Lymph Node Harvesting Impact Outcomes After Total Gastrectomy for Cancer? A Multi-Institutional
F Martinet-Kosinski1, O Bacoeur-Ouzillou2, B Pereira3
1Department of Digestive Surgery, Clermont-Ferrand University Hospital, Clermont-Ferrand, France. fmartinet@chu-clermontferrand.fr.
Annals of Surgical Oncology
|November 19, 2025
Summary
Splenic hilar lymph node (LN10) harvesting during total gastrectomy for gastric cancer does not improve survival outcomes. This study found no significant benefit in overall survival or recurrence-free survival, even for high-risk patients.
Area of Science:
- Surgical Oncology
- Gastrointestinal Surgery
- Gastric Cancer Research
Background:
- The role of splenic hilar lymph node (LN10) dissection in total gastrectomy for gastric cancer remains controversial.
- Concerns exist regarding the impact of LN10 harvesting on oncologic outcomes and potential increases in surgical morbidity.
Purpose of the Study:
- To evaluate the clinical value and oncologic impact of LN10 harvesting during total gastrectomy for gastric cancer.
- To determine if LN10 dissection offers survival benefits, particularly in high-risk patient groups.
Main Methods:
- Retrospective analysis of 514 patients from the ADENOKGAST multi-institutional database (2007-2017).
- Propensity score analysis using inverse probability of treatment weighting.
- Development of a recurrence risk score based on preoperative factors.
- Survival analysis using Kaplan-Meier methods and Cox models.
Main Results:
- No significant differences in 30-day severe postoperative morbidity or 90-day mortality between LN10+ and LN10- groups.
- Slightly increased hospital stay in the LN10+ group (20.6 vs 19.7 days).
- Similar recurrence rates (36% vs 40%), recurrence location, overall survival (OS), and recurrence-free survival (RFS) between groups.
Conclusions:
- LN10 harvesting does not enhance OS or RFS in patients undergoing total gastrectomy for gastric cancer.
- No survival benefit was observed from LN10 dissection, even in patients identified as high-risk for recurrence.
