Clinical significance of No.14v lymph node dissection in advanced lower gastric cancer        YANG Jia-hua*, CHEN Lei, DONG Ping, et al. *Department of General Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
Corresponding author: LIU Ying-bin, E-mail: laoniulyb@163.com
Abstract    Objective    To study if clinicopathological variates are related to No.14v lymph nodes metastasis in advanced lower gastric cancer and how the prognostic significance of lymph node metastasis can instruct the optimal choice in lymph node dissection. Methods    The clinicopathological data of 115 patients received radical resections (D2+No.14v) between January 2008 and December 2008 in Department of General Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were analyzed retrospectively. The relationship between different clinicopathological factors and lymph node metastasis was analyzed. Besides, how lymph node metastasis influenced prognosis of patients was investigated. Results    The overall No.14v lymph node metastasis rate (metastatic/examined lymph node) was 18.41% (37/201). The positive rate of No.14v lymph nodes was 20.87% (24/115). Metastasis to the No.14v lymph nodes was associated with tumor diameter, tumor cell grading, depth of invasion, TNM staging and No.6 lymph nodes metastasis（P＜0.05）. Meanwhile it was not associated with gender, age or Bormann types（P＞0.05）. Multivariate analysis showed that tumor size, depth of invasion, TNM stage and No.6 lymph nodes metastasis were independent risk factors for No.14v lymph nodes metastasis（P＜0.05）. Average three-year survival period in the whole group was 40 months. The three-year survival rate of patients with negative No.14v lymph nodes was 73.67%, which was significantly higher than those with positive No.14v lymph nodes (37.5%) (P<0.05). Conclusion    No.14v lymph node dissection for advanced lower gastric cancer is necessary and feasible.