Ding P, et al. - The risk factors for No.10 and No.11 lymph node metastases in advanced proximal gastric cancer patients and the survival significance of their dissection were investigated. Among a total of 873 advanced proximal gastric cancer patients who underwent curative gastrectomy with or without splenectomy or pancreaticosplenectomy, researchers analyzed the clinicopathological characteristics of 152 patients who underwent splenectomy or pancreaticosplenectomy. They observed very poor prognoses for patients with No.10 and No.11 lymph node metastases. Independent risk factors for No.10 and No.11 lymph node metastases were tumor invasion of the greater curvature and No.2 and No.4 lymph node metastases. In proximal gastric cancer patients without direct cancer invasion of the spleen and pancreas, they observed no increased survival in correlation with splenic hilar or splenic artery lymph node dissection. This was observed regardless of whether splenectomy, pancreaticosplenectomy, or spleen-preserving lymphadenectomy was performed.