Evaluation of Optimal Lymph Node Dissection in Remnant Gastric Cancer Based on Initial Distal Gastrectomy.

BACKGROUND/AIM: The purpose of this study was to reveal the optimal lymph node (LN) dissection in remnant gastric cancer (RGC) patients.

PATIENTS AND

METHODS

We retrospectively analyzed 46 RGC patients divided into two groups: patients who underwent initial gastrectomy for benign (group B) and malignant (group M) diseases.

RESULTS

Metastasis was more frequently observed at the left (nos. 2, 4sa, 4sb, 10, and 11p/d) and right (nos. 1, 3, 4d, 7, 8a, and 12a) side LNs of RGC in groups M and B. Modified IEBLD scores (frequency of LN metastasis by median survival time of patients with metastatic LNs) were high at station nos. 10 (4.7), 11p/d (4.3/9.9), and 16 (4.3) in group M and nos. 1 (2.1), 7 (1.9) and mesojejunal (3.0) in group B.

CONCLUSION

After lymphadenectomy for initial gastric cancer, lymphatic flow toward the splenic artery was predominant. Therefore, splenectomy with para-aortic LN dissection is an option.