31. Studies on para-aortic lymph nodes metastasis and dissection for advanced gastric cancer

Objective: To assess the relationship between the para-aortic lymph node (No.16 LN) metastasis and the biological behavior of gastric cancer and make out the appropriate indications for the para-aortic lymph node dissection (PAND).
Methods: 100 cases of advanced gastric cancer (AGC) without remote metastasis were subjected to D2 group and D2+PAND group randomly. No.16 LN micrometastasis was found via CK20 mRNA express detected by RT-PCR. Clinicalpathological studies were carried out for all the cases.
Results: There was no operative mortality and the incidence of complications occurring in our cases was not signicantly different except for operative time (P<0.05). Metastasis or micrometastasis of No.16 LN (30%) was found in 15 cases of 50 cases in D2+PAND Group. Tumor size, N 94 stage and pathological type were relative to No.16 LN positive (P<0.05).
Conclusions: The rate of metastasis or micrometastasis of No.16 LN in AGC is high remarkably, it is relative notably to the pathological character. PAND operation is safe and necessary for AGC abiding by the right operative indication. The impact of para-aortic lymph node dissection procedure on the long –term prognosis of AGC remains to be clarified by further studies.