Gastrectomy with lymph node dissection remains the gold standard for curative treatment of gastric cancer. Dissection of splenic hilar lymph nodes has been included as a part of D2 lymph node dissection for proximal gastric cancer. Previously, pancreatico-splenectomy has been performed for dissecting splenic hilar lymph nodes, followed by pancreas-preserving splenectomy and spleen-preserving lymphadenectomy. However, the necessity of routine splenectomy or splenic hilar lymph node dissection has been under debate due to the increased morbidity caused by splenectomy and the poor prognostic feature of splenic hilar lymph node metastasis. In contrast, the relatively high incidence of splenic hilar lymph node metastasis, survival advantage, and therapeutic value of splenic hilar lymph node dissection in some patient subgroups, as well as the effective use of novel technologies, still supports the necessity and applicability of splenic hilar lymph node dissection. In this review, we aimed to evaluate the need for splenic hilar lymph node dissection and suggest the subgroup of patients with favorable outcomes.
Bibliographical noteFunding Information:
This study was supported by a grant received from the Investigator Sponsored Research Program (ISR-2017-10924), Covidien Private Limited (Medtronic). This funding source had no role in the design of this study and will not have any role during its execution, data analyses and interpretation, or decision to submit results for presentation or publication.
W.J.H. has funds in Hutom and received a research grant from Medtronic and GC Pharma and consulting fee from Ethicon and Verb Surgical. The other author has no conflicts of interest to declare.
© 2020. Korean Gastric Cancer Association.
All Science Journal Classification (ASJC) codes
- Cancer Research