Most important lymph node information in gastric cancer: multivariate prognostic study - PubMed (original) (raw)
Most important lymph node information in gastric cancer: multivariate prognostic study
Y Adachi et al. Ann Surg Oncol. 2000 Aug.
Abstract
Background: In gastric cancer, the level and number of lymph node metastases is useful for predicting survival, and there are several staging systems for lymph node metastasis. The aim of this study was to compare the several lymph node classifications and to clarify the most important lymph node information associated with prognosis using multivariate analysis.
Methods: A total of 106 patients with histologically node-positive gastric cancer treated by radical gastrectomy and extended lymph node dissection (D2, D3) were studied. The level of lymph node metastasis was categorized simply as Level I nodes (perigastric, No.1-6), Level II nodes (intermediate, No.7-9), and Level III nodes (distant, No.10-16), irrespective of the tumor location. The Level II nodes included lymph nodes along the left gastric artery, common hepatic artery, and celiac trunk.
Results: Overall 5-year survival rate was 51%. Univariate analysis showed that 5-year survival rate was significantly influenced by the level of positive nodes (P < .01), total number of positive nodes (P < .01), number of positive Level I nodes (P < .01), and number of positive Level II nodes (P < .01), in addition to the tumor location (P < .05), tumor size (P < .05), gross type (P < .01), and depth of wall invasion (P < .01). Of these, independent prognostic factors associated with 5-year survival rate were the number of positive Level II nodes (0-1 vs. > or =2) (62% vs. 19%, P < .01) and the depth of wall invasion (within vs. beyond muscularis) (79% vs. 43%, P < .01).
Conclusions: Among several staging systems for lymph node metastases, the number of positive Level II nodes provided the most powerful prognostic information in patients with node-positive gastric cancer. When there were two or more metastases in the Level II nodes, prognosis was poor even after D2 or D3 gastrectomy.
Similar articles
- [Prognostic factors of lymph node-negative metastasis gastric cancer].
Sun D, Xu H, Huang J. Sun D, et al. Zhonghua Wei Chang Wai Ke Za Zhi. 2017 Feb 25;20(2):190-194. Zhonghua Wei Chang Wai Ke Za Zhi. 2017. PMID: 28226354 Chinese. - [Analysis of risk factors and prognosis of No.8p lymph node metastasis in cases with advanced gastric cancer].
Chen L, Wei S, Ye Z, Zeng Y, Zheng Q, Xiao J, Wang Y, Zhuo C, Lin Z, Li Y. Chen L, et al. Zhonghua Wei Chang Wai Ke Za Zhi. 2017 Feb 25;20(2):218-223. Zhonghua Wei Chang Wai Ke Za Zhi. 2017. PMID: 28226359 Chinese. - Perigastric lymph node status as a prognostic indicator in patients with gastric cancer.
Adachi Y, Suematsu T, Shiraishi N, Tanimura H, Morimoto A, Kitano S. Adachi Y, et al. Br J Surg. 1998 Sep;85(9):1281-4. doi: 10.1046/j.1365-2168.1998.00833.x. Br J Surg. 1998. PMID: 9752878 - Multivariate prognostic study on large gastric cancer.
Shiraishi N, Sato K, Yasuda K, Inomata M, Kitano S. Shiraishi N, et al. J Surg Oncol. 2007 Jul 1;96(1):14-8. doi: 10.1002/jso.20631. J Surg Oncol. 2007. PMID: 17582596 Review. - [Current status and research progress of lymph node dissection in advanced upper gastric cancer].
Zhang J, Wang J, Hu W. Zhang J, et al. Zhonghua Wei Chang Wai Ke Za Zhi. 2018 Feb 25;21(2):236-240. Zhonghua Wei Chang Wai Ke Za Zhi. 2018. PMID: 29492924 Review. Chinese.
Cited by
- Prognosis of gastric cancer patients with node-negative metastasis following curative resection: outcomes of the survival and recurrence.
Deng J, Liang H, Sun D, Zhang R, Zhan H, Wang X. Deng J, et al. Can J Gastroenterol. 2008 Oct;22(10):835-9. doi: 10.1155/2008/761821. Can J Gastroenterol. 2008. PMID: 18925308 Free PMC article. - The prognostic value of β-catenin and LEF-1 expression in patients with operable gastric carcinoma.
Kaya S, Gumus M, Gurbuz Y, Cabuk D, Acikgoz O, Temiz S, Uygun K. Kaya S, et al. Am J Transl Res. 2016 Feb 15;8(2):1228-36. eCollection 2016. Am J Transl Res. 2016. PMID: 27158409 Free PMC article. - Suppression of VEGFR-3 signaling inhibits lymph node metastasis in gastric cancer.
Shimizu K, Kubo H, Yamaguchi K, Kawashima K, Ueda Y, Matsuo K, Awane M, Shimahara Y, Takabayashi A, Yamaoka Y, Satoh S. Shimizu K, et al. Cancer Sci. 2004 Apr;95(4):328-33. doi: 10.1111/j.1349-7006.2004.tb03211.x. Cancer Sci. 2004. PMID: 15072591 Free PMC article. - Serum VEGFR-3 and survival of advanced gastric cancer patients treated with FOLFOX.
Ni XF, Wu CP, Jiang JT. Ni XF, et al. World J Gastroenterol. 2010 May 7;16(17):2163-9. doi: 10.3748/wjg.v16.i17.2163. World J Gastroenterol. 2010. PMID: 20440858 Free PMC article. - The distance of proximal resection margin dose not significantly influence on the prognosis of gastric cancer patients after curative resection.
Kim MG, Lee JH, Ha TK, Kwon SJ. Kim MG, et al. Ann Surg Treat Res. 2014 Nov;87(5):223-31. doi: 10.4174/astr.2014.87.5.223. Epub 2014 Oct 24. Ann Surg Treat Res. 2014. PMID: 25368847 Free PMC article.
MeSH terms
LinkOut - more resources
Full Text Sources
Medical