Role of D2 gastrectomy in gastric cancer with clinical para-aortic lymph node metastasis

Figure 1 Flow chart. CT: Computed tomography; SOX: S-1 plus oxaliplatin; DOS: Docetaxel/oxaliplatin/S-1; DOX: Docetaxel/capecitabine/oxaliplatin; DCS: Docetaxel/cisplatin/S-1; XELOX: Capecitabine/oxaliplatin; FOLFOX: 5-fluorouracil/leucovorin/oxaliplatin; FOLFOXIRI: Irinotecan/5-fluorouracil/leucovorin/oxaliplatin.

Figure 2 Violin plots of index diameter distribution of all patients. A: Violin plots of index diameter distribution at baseline of patients who underwent D2 resection or not; B: Violin plots of index diameter distribution at baseline of patients with involvement of more than two para-aortic lymph node stations or not; C: Violin plots of index diameter distribution of patients who underwent D2 resection or not after initial chemotherapy; D: Violin plots of index diameter distribution after initial chemotherapy of patients with involvement of more than two para-aortic lymph node stations or not. CA: Chemotherapy alone; C+D2G: Chemotherapy plus D2 gastrectomy; PAN: Para-aortic lymph node.

Figure 3 Kaplan-Meier curves for survival of the gastric cancer patients with clinically positive para-aortic node metastasis. A: Overall survival and progression-free survival of all patients; B: Overall survival of patients who underwent chemotherapy with or without D2 resection; C: Progression-free survival of patients who underwent chemotherapy with or without D2 resection; D: Overall survival of all patients assessed by overall response; E: Overall survival of all patients assessed by chemotherapy response of the primary tumor; F: Overall survival of all patients assessed by chemotherapy response of the metastatic para-aortic lymph node. CR: Complete response; PR: Partial response; SD: Stable disease; PD: Progressive disease; NE: Not evaluable.

Figure 4 Computed tomography images of a gastric cancer patient with clinically positive para-aortic node metastasis who has survived for more than 70. 1 mo. A: At baseline; B: Incomplete response of para-aortic lymph nodes after two cycles of preoperative chemotherapy (1.5 mo after initial treatment); C: After D2 gastrectomy (2.2 mo after initial treatment); D: Follow-up after adjuvant chemoradiotherapy (70.1 months after initial treatment).