GC is one of the most common malignant tumors of the digestive system. Individualized effective treatment must be developed to enhance the postoperative survival rate of GC patients. LN metastasis is an important factor decreasing the prognosis of patients with GC, and thorough LN dissection significantly influences the success or failure of the surgery. Currently, the D2 LN dissection technique is considered the standard operation for advanced GC. No. 10 LN dissection is critical, and difficulties in D2 radical advanced upper GC have been reported. According to previous studies, the No. 10 LN metastasis rate is approximately 9.5% to 27.9% [1–3]. The results of the present study showed that the incidence of No. 10 LN metastasis was 9.55 in upper GC. Chikara et al.  reported that the 5-year OS of No. 10 LN metastasis-positive patients was significantly lower than that of No. 10 LN metastasis-negative patients (23.8% vs. 41.4%, P < 0.05), and these authors suggested that spleen regional LN metastasis has a significant effect on the prognosis of patients. Shin et al.  showed that the 5-year OS of No. 10 LN metastasis-positive patients was significantly lower than that of No. 10 LN metastasis-negative patients (11.04% vs. 51.57%, P < 0.001). Therefore, the dis-section of the No. 10 LN is necessary in advanced upper GC; otherwise, the radical excision of the tumor will be decreased. The concept of laparoscopic spleen-preserving SHLND is becoming increasingly accepted with the increasing application of laparoscopic GC radical surgery and advancements in surgical instruments. However, whether all cases of advanced upper GC should be treated using this laparoscopic spleen-preserving SHLND technique has not yet been determined. Therefore, how to predict splenic hilar LN metastasis and characterize the indications for SHLND has become a topic of considerable interest in the research community. However, previous studies analyzing the risk factors for No. 10 LN metastasis were confined to postoperative-related factors and thus were not applicable for preoperative prediction. To our knowledge, the present study is the first preoperative retrospective study investigating the factors related to No. 10 LN metastasis in upper GC.