Objective: D2 lymphadenectomy has been increasingly regarded as standard surgical procedure for advanced gastric cancer (GC), while necessity No.14v lymph node dissection for distal GC is still controversial.
Methods: A total of 920 distal GC patients receiving at least D1+ (D1+7, 8a, 9) or D2 lymph node dissection in our center were enrolled in this study, of whom, 243 patients also had the No.14v lymph node dissected. Other 677 patients without No.14v lymph node dissection were used for comparison.
Results: Forty-five (18.5%) patients had No.14v lymph node metastasis. There was no significant difference in overall survival (OS) rate between patients with and without No.14v lymph node dissection. Following stratified analysis, in TNM stages I, II, IIIa and IV, No.14v lymph node dissection did not affect OS. In multivariate analysis, No.14v lymph node dissection was found to be an independent prognostic factor in patients with TNM stage IIIb/IIIc GC (hazard ratio =0.670, 95% confidence interval =0.506-0.886, P=0.005).
Conclusions: Adding No.14v lymph node to D2 lymphadenectomy may be associated improved OS for middle and lower GC staged TNM IIIb/IIIc.
