178P - Survival benefit of splenic hilar lymph nodes (no.10) dissection in B4 type gastric carcinoma: An IPTW propensity score analysis of large multi-institutional data

Background

Although splenic hilar lymph node (no.10 LN) dissection did not prolong survival in proximal gastric cancer, B4-type gastric cancer remains uninvestigated for the necessity of no.10 LN dissection. This is the first study investigating the treatment effect of no.10 LN dissection in B4-type gastric cancer.

Methods

We retrospectively reviewed patients who underwent total gastrectomy for B4-type gastric cancer between 2006 and 2016 in four major institutions in Korea. Using the inverse probability of treatment weighting (IPTW) using the propensity score, the long-term survival was compared between patients with and without no.10 LN dissection.

Results

There were 540.4 patients in the no.10-dissection group and 532.69 patients in the no-dissection group in the IPTW sample. The IPTW sample showed well-balanced clinicopathological characteristics between the two groups. The no.10-dissection group showed significantly better survival than the no-dissection group (5-ysr 45.7% vs. 38.6%, p=0.036). Multivariate analysis revealed that no.10 LN dissection was an independent prognostic factor (adjusted hazard ratio [HR] = 0.747, 95% CI = 0.593 – 0.940) after adjusting for other prognostic factors.

Conclusions

No.10 LN dissection during total gastrectomy may prolong survival in B4-type gastric cancer. A large randomized controlled trial may be warranted to validate these results.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.