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| 1 | Evaluation of rational extent lymphadenectomy for local advanced gastric cancer显示文摘Based upon studies from randomized clinical trials, the extended(D2) lymph node dissection is now recommended as a standard procedure for local advanced gastric cancer worldwide. However, the rational extent lymphadenectomy for local advanced gastric cancer has remained a topic of debate in the past decades. Due to the limitation of low metastatic rate in para-aortic nodes(PAN) in JCOG9501, the clinical benefit of D2+ para-aortic nodal dissection(PAND) for patients with stage T4 and/or stage N3 disease, which is very common in China and other countries except Japan and Korea, cannot be determined. Furthermore, the role of splenectomy for complete resection of No.10 and No.11 nodes has been controversial, and however, the final results from the randomized trial of JCOG0110 have yet to be completed. Gastric cancer with the No.14 and No.13 lymph node metastasis is defined as M1 stage in the current version of the Japanese classification. We propose that D2+No.14 v and +No.13 lymphadenectomy may be an option in a potentially curative gastrectomy for tumors with apparent metastasis to the No.6 nodes or infiltrate to duodenum. The examined lymph node and extranodal metastasis are significantly associated with the survival of gastric cancer patients. | Han Liang Jingyu Deng | 2016 | Chinese Journal of Cancer Research2016，28，4： | 9 |
| 2 | 进展期胃癌伴腹主动脉旁淋巴结转移综合治疗的研究显示文摘目的探讨应用新辅助化疗联合手术治疗进展期胃癌患者伴腹主动脉旁淋巴结转移的安全性及预后。方法回顾性分析2015年1月至2017年6月福建省肿瘤医院胃肠外科收治的术前影像学提示腹主动脉旁淋巴结转移的25例胃癌患者的临床病理资料。所有患者术前均给予奥沙利铂联合替吉奥(SOX)方案化疗3个周期以后对达到腹主动脉旁淋巴结疾病稳定、部分缓解或完全缓解的患者进行D_(2)+腹主动脉旁淋巴结清扫术,术后用SOX方案进行5个周期的化疗。结果本组25例患者均完成SOX方案新辅助化疗3个周期,其中疾病进展2例,疾病稳定6例,部分缓解17例。23例患者接受手术治疗,19例患者获得R_(0)切除,总体R_(0)切除率为76%。全组共清扫腹主动脉旁淋巴结128个,其中转移淋巴结34个,淋巴结转移率44%,淋巴结转移度27%。5例(22%)患者出现术后并发症,无围手术期死亡。25例患者中位无进展生存时间和中位总生存时间分别为20、29个月。1、3年总生存率分别为80%、48%,1、3年无疾病进展生存率分别为72%、38%。10例腹主动脉旁淋巴结转移患者1年生存率为70%,3年生存率为17%。多因素分析表明,新辅助化疗疗效为独立预后因素。结论新辅助化疗是影响进展期胃癌伴腹主动脉旁淋巴结转移患者生存的独立预后因素。 | 魏晟宏 王益 叶再生 郑钧尹 陈书 曾奕 林志涛 王志纬 陈小玲 陈路川 | 2021 | 中华普通外科杂志2021，36，4： | 6 |
| 3 | 进展期远端胃癌行扩大淋巴结清扫术的研究进展显示文摘淋巴结清扫范围一直是胃癌外科的热点问题。D2根治术作为进展期胃癌标准手术已达成共识,然而扩大淋巴结清扫的价值依然存在争议。进展期远端胃癌第14v组淋巴结转移率较高,D2+14v组淋巴结清扫有可能改善第6组淋巴结明显转移患者预后;尽管胃癌腹主动脉旁淋巴结转移视为M1,但D2+16a2/b1淋巴结清扫对局限性第16组淋巴结转移患者可能获益;而D2+13组淋巴结清扫有可能提高伴有十二指肠浸润胃癌患者生存率。本文旨在探讨扩大淋巴结清扫在胃癌中的价值,以期为临床提供依据,现就进展期远端胃癌扩大淋巴结清扫的研究进展进行综述。 | 张树朋 梁月祥 | 2018 | 中国肿瘤临床2018，45，21： | 2 |
| 4 | Advances in para-aortic nodal dissection in gastric cancer surgery: A review of research progress over the last decade显示文摘Approximately 17%-40%of para-aortic lymph node(PAN)metastasis occurs in patients with advanced gastric cancer.As the third tier of lymphatic drainage of the stomach and the final station in front of the systemic circulation,PAN infiltration is defined as distant metastasis and plays a key role in the evaluation of the prognosis of advanced gastric cancer.Many clinical factors including tumor size≥5 cm,pT3 or pT4 depth of tumor invasion,pN2 and pN3 stages,the macroscopic type of Borrmann Ⅲ/Ⅳ,and the diffuse/mixed Lauren classification are indicators of PAN metastasis.Whether PAN dissection(PAND)should be performed on patients with or without the macroscopic PAN invasion remains unascertained,regardless of the numerous retrospective comparative studies reported on the improved prognosis over D2 alone.Another paradoxical result from many other studies showed no significant difference in the overall survival between these two lymphadenectomies.A phase Ⅱ trial launched by the Japan Clinical Oncology Group indicated that two or three courses of S-1 and cisplatin preoperatively followed by radical surgery with D2+PAND and postoperative S-1 is the current standard strategy for the treatment of patients with extensive lymph node metastasis,and this regimen could be substituted by a promising strategy with effective combination chemotherapy or suitable chemotherapy duration.This review focuses on the advances in radical gastrectomy plus PAND with or without chemotherapy for patients with advanced gastric cancer. | Yin-Ping Dong Jing-Yu Deng | 2020 | World Journal of Clinical Cases2020，8，13： | 2 |
| 5 | 伴有No.16淋巴结转移胃癌治疗策略显示文摘拟行No.16淋巴结清扫的胃癌病人须行充分的术前评估及术前分期,经过多学科讨论决定个体化治疗方案。目前,预防性No.16淋巴结清扫的临床意义已被否定,治疗性No.16淋巴结清扫目前仍有争议。其指征包括无其他非根治因素及No.16淋巴结转移不超过3枚。手术多采用右侧入路(右侧Toldts间隙),清扫范围主要集中于No.16a2和b1区。No.16淋巴结清扫并不增加手术并发症发生率,但术者需具有丰富的D2淋巴结清扫和扩大淋巴结清扫经验。新辅助化疗可使肿瘤降期,增加R0手术的机会。 | 何裕隆 | 2015 | 中国实用外科杂志2015，35，10： | 2 |
| 6 | 胃癌行腹主动脉旁淋巴结清扫的研究进展显示文摘手术治疗是治疗胃癌的主要方式之一,标准的术中淋巴结清扫尤为重要。关于胃癌患者是否行腹主动脉旁淋巴结清扫(para-aortic lymph node dissection,PAND)仍存在争议。预防性PAND的意义被否定,但治疗性PAND的效果还有待进一步的研究去证实。术前化疗联合规范的手术治疗可能是未来进展期胃癌伴腹主动脉旁淋巴结转移的标准治疗模式。本文就胃癌行PAND的研究进行综述,以期为临床实践提供指导。 | 于鹏程 徐志远 王以 胡灿 程向东 | 2022 | 中国肿瘤临床2022，49，17： | 0 |
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