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Related Experiment Videos

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
PubMed
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.

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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).

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  • 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.