Scope definition and resection significance of No. 12a group lymph nodes in gastric cancer

Huang, Yongjian; Zhu, Guangwei; Zheng, Wei; Jin, Hua; Yang, Shugang; Zhuang, Jinfu; Wang, Jinzhou; Ye, Jianxin

doi:10.3892/mco.2016.911

Cited by 5 publications

(7 citation statements)

References 9 publications

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“…The modified illustration of such scope definition of No. 12a, 12b, and 12p is presented as Figure 2 , similar to published demonstration ( 10 , 11 ).…”

Section: Methodssupporting

confidence: 87%

“…12a, 12b, and 12p LNs is not clearly defined according to the guidelines of American Joint Committee on Cancer (AJCC)/Union for International Cancer Control or Japanese treatment guidelines, we utilized a peer consensus which was capable to describe No. 12 LN dissection during operation ( 10 ). The modified illustration of such scope definition of No.…”

Section: Methodsmentioning

confidence: 99%

“…The surgical procedures of No. 12 lymph node dissection were performed as previously described ( 10 ). In short, hepatoduodenal ligament was fully exposed from the first part of duodenum to the lower border of the right liver.…”

Section: Methodsmentioning

confidence: 99%

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Extensive Dissection at No. 12 Station During D2 Lymphadenectomy Improves Survival for Advanced Lower-Third Gastric Cancer: A Retrospective Study From a Single Center in Southern China

et al. 2022

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BackgroundD2 lymphadenectomy including No. 12a dissection has been accepted as a standard surgical management of advanced lower-third gastric cancer (GC). The necessity of extensive No. 12 nodes (No. 12a, 12b, and 12p) dissection remains controversial. This study aims to explore its impact on long-term survival for resectable GC.MethodsFrom 2009 to 2016, 353 advanced lower-third GC patients undergoing at least D2 lymphadenectomy during a radical surgery were included, with 179 patients receiving No. 12a, 12b, and 12p dissection as study group. A total of 174 patients with No. 12a dissection were employed as control group. Surgical and long-term outcomes including 90-day complications incidence, therapeutic value index (TVI), 3-year progression-free survival (PFS), and 5-year overall survival (OS) were compared between both groups.ResultsNo. 12 lymph node metastasis was observed in 20 (5.7%) patients, with 10 cases in each group (5.6% vs. 5.7%, p = 0.948). The metastatic rates at No. 12a, 12b, and 12p were 5.7%, 2.2%, and 1.7%, respectively. The incidence of 90-day complications was identical between both groups. Extensive No. 12 dissection was associated with increased TVI at No. 12 station (3.9 vs. 0.6), prolonged 3-year PFS rate (67.0% vs. 55.9%, p = 0.045) and 5-year OS rate (66.2% vs. 54.0%, p = 0.027). The further Cox-regression analysis showed that the 12abp dissection was an independent prognostic factor of improved survival (p = 0.026).ConclusionAdding No. 12b and 12p lymph nodes to D2 lymphadenectomy might be effective in surgical treatment of advanced lower-third GC and improve oncological outcomes compared with No. 12a-based D2 lymphadenectomy.

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“…The modified illustration of such scope definition of No. 12a, 12b, and 12p is presented as Figure 2 , similar to published demonstration ( 10 , 11 ).…”

Section: Methodssupporting

confidence: 87%

Section: Methodsmentioning

confidence: 99%

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Extensive Dissection at No. 12 Station During D2 Lymphadenectomy Improves Survival for Advanced Lower-Third Gastric Cancer: A Retrospective Study From a Single Center in Southern China

et al. 2022

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“…It is situated along the proper hepatic artery, limited superiorly by the hepatic duct confluence, the bile duct to the right, the hepatoduodenal ligament region to the left and the pancreatic border inferiorly up to the anterior aspect of the portal vein. Due to the proximity of important vascular and bile structures, the risk of surgical complications secondary to iatrogenic injury demands careful dissection of the LN in this region (37,38).…”

Section: Bile Duct Injurymentioning

confidence: 99%

Management of postoperative complications of lymphadenectomy

Barchi¹,

Charruf²,

Oliveira³

et al. 2016

Transl. Gastroenterol. Hepatol.

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Gastric cancer remains a disease with poor prognosis, mainly due to its late diagnosis. Surgery remains as the only treatment with curative intent, where the goal is radical resection with free-margin gastrectomy and extended lymphadenectomy. Over the last two decades there has been an improvement on postoperative outcomes. However, complications rate is still not negligible even in high volume specialized centers and are directly related mainly to the type of gastric resection: total or subtotal, combined with adjacent organs resection and the extension of lymphadenectomy (D1, D2 and D3). The aim of this study is to analyze the complications specific-related to lymphadenectomy in gastric cancer surgery.

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“…12a LNM is a sign of disease progression, which explained why No. 12a LN positive patients usually have a poor prognosis ( 13 , 17 ). In addition, No.…”

Section: Discussionmentioning

confidence: 99%

Pattern of No. 12a lymph node metastasis in gastric cancer

Shu

Sun

Liu

et al. 2021

Chinese Journal of Cancer Research

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Objective The current standard D2 lymphadenectomy for gastric cancer (GC) includes dissection of lymph nodes (LNs) along the proper hepatic artery (No. 12a), however, the survival benefit remains controversial. The purpose of this study was to evaluate the pattern of No. 12a LN metastasis (LNM) in GC and explore the indications for No. 12a LN dissection. Methods Medical records of 413 consecutive GC patients who underwent curative surgery in Zhongshan Hospital, Fudan University between January 2015 and December 2018 were enrolled and reviewed retrospectively. The correlation between No. 12a LNM and clinicopathologic characteristics of patients was analyzed. Results The overall incidence of No. 12a LNM was 2.67% (11/413). Tumor location (P=0.012), depth of tumor infiltration (P<0.01) and N stage (P=0.018) were significant factors associated with No. 12a LNM. All the tumors with No. 12a LNM involved the lower third of the stomach and were in T3−4 stages. Patients with No. 12a LNM had extensive LNM than those without (20.91±4.25 vs . 5.0±0.54, P<0.001). For advanced GC patients (stage III/IV) with tumors involving the lower third of the stomach, the incidence of No. 12a LNM increased to 10.7% (11/103). Patients with No. 12a LNM had a significantly poorer recurrence-free survival (RFS) (P=0.005) and overall survival (OS) (P=0.017). According to the result of multivariable Cox regression, No. 12a LNM was not an independent impact factor on RFS and OS. Conclusions The overall incidence of No. 12a LNM was low but it was much higher in GC patients who had very advanced tumors involving the lower third of the stomach. No. 12a LN dissection should be considered for these patients to improve the survival outcomes.

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Scope definition and resection significance of No. 12a group lymph nodes in gastric cancer

Cited by 5 publications

References 9 publications

Extensive Dissection at No. 12 Station During D2 Lymphadenectomy Improves Survival for Advanced Lower-Third Gastric Cancer: A Retrospective Study From a Single Center in Southern China

Extensive Dissection at No. 12 Station During D2 Lymphadenectomy Improves Survival for Advanced Lower-Third Gastric Cancer: A Retrospective Study From a Single Center in Southern China

Management of postoperative complications of lymphadenectomy

Pattern of No. 12a lymph node metastasis in gastric cancer

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