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Gastric cancer with extragastric lymph node metastasis: multivariate prognostic study
Norio Shiraishi1, Yosuke Adachi, Seigo Kitano
1First Department of Surgery, Oita Medical University, 1-1 Idaigaoka, Hasama-machi, Oita 879-5593, Japan.
Summary
Prognostic factors for gastric cancer with extragastric lymph node metastasis were identified. Operative curability and depth of invasion are key independent factors for survival after gastrectomy.
Area of Science:
- Oncology
- Surgical Gastroenterology
Background:
- Gastric cancer prognosis is complex, especially with extensive lymph node metastasis.
- Limited comprehensive studies exist on prognostic factors for advanced gastric cancer with extragastric lymph node spread.
Purpose of the Study:
- To identify independent prognostic factors in gastric cancer patients with extragastric lymph node metastasis.
- To clarify survival predictors following radical gastrectomy and extended lymph node dissection.
Main Methods:
- Multivariate analysis of 18 clinicopathologic factors in 121 gastric cancer patients.
- Kaplan-Meier, Mantel-Cox, and Cox proportional hazards models were used for survival analysis.
- Patients underwent radical gastrectomy with D2 or D3 lymph node dissection.
Main Results:
- Overall 5-year survival was 32%; after curative gastrectomy, it was 37%.
- Independent prognostic factors identified were operative curability and depth of wall invasion.
- Survival after curative gastrectomy was primarily influenced by depth of invasion (T1, T2 vs. T3).
Conclusions:
- Operative curability and depth of wall invasion are crucial independent prognostic factors for gastric cancer with extragastric lymph node metastasis.
- Achieving long-term survival is possible when patients lack serosal invasion (T1, T2) and undergo curative gastrectomy.