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Most important lymph node information in gastric cancer: multivariate prognostic study.
Y Adachi1, N Shiraishi, T Suematsu
1First Department of Surgery, Oita Medical University, Japan.
Annals of Surgical Oncology
|August 18, 2000
Summary
The number of positive Level II lymph nodes is a crucial factor for predicting survival in gastric cancer patients. Two or more Level II metastases indicate a poor prognosis, even after extensive surgery.
Area of Science:
- Surgical Oncology
- Gastroenterology
- Cancer Research
Background:
- Lymph node metastasis is critical for gastric cancer prognosis.
- Existing staging systems for lymph node metastasis vary.
- Accurate prognostic indicators are needed for node-positive gastric cancer.
Purpose of the Study:
- To compare various lymph node classifications in gastric cancer.
- To identify the most significant lymph node information for prognosis.
- To utilize multivariate analysis for prognostic factor identification.
Main Methods:
- Studied 106 node-positive gastric cancer patients undergoing radical gastrectomy (D2, D3).
- Classified lymph node metastasis into Level I (perigastric), Level II (intermediate), and Level III (distant).
- Level II nodes included those along the left gastric artery, common hepatic artery, and celiac trunk.
Main Results:
- Overall 5-year survival was 51%.
- Univariate analysis showed positive nodes, number of positive nodes (total, Level I, Level II), tumor location, size, gross type, and invasion depth influenced survival.
- Independent prognostic factors were the number of positive Level II nodes (0-1 vs. ≥2) and depth of wall invasion.
Conclusions:
- The number of positive Level II lymph nodes is the strongest prognostic indicator in node-positive gastric cancer.
- Two or more Level II metastases predict a poor prognosis, irrespective of gastrectomy extent (D2, D3).
- This finding aids in refining staging and treatment strategies for gastric cancer.