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Updated: Jun 16, 2025
Sentinel Lymph Node Mapping and Biopsy for Endometrial Cancer at Early Stage with Laparoscopy
Published on: August 19, 2021
Lymph node metastasis mapping and prognostic analysis of early gastric cancer
Wenqian Ma1, Honghai Guo2, Peigang Yang2
1The Third Department of Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang, China; Hebei Key Laboratory of Precision Diagnosis and Comprehensive Treatment of Gastric Cancer, Shijiazhuang, China; Big data analysis and mining application for precise diagnosis and treatment of gastric cancer, Hebei Provincial Engineering Research Center, Shijiazhuang, China; Department of Endoscopy, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China.
Background:
Currently, numerous studies focus on the analysis of risk factors for lymph node metastasis in early gastric cancer, but few studies analyze the drainage patterns of metastatic lymph nodes.
Methods:
Data were retrospectively analyzed from a database of gastric cancer resections from 2014 to 2018. The cohort included 786 pT1 patients with complete data. Outcomes evaluated were lymph node metastasis frequencies, survival analyses, and risk factors affecting prognosis.
Results:
The overall lymph node metastasis rate was 23.7%. The 5-year overall survival (OS) rate (54.8% vs 95.7%; P <.001) and disease-free survival (DFS) rate (48.4% vs 95.7%; P <.001) of patients with node-positive disease were significantly worse than those of patients with node-negative disease. Multivariable Cox regression identified tumor size of >2 cm (P =.007; P <.001), poor differentiation (P =.007; P <.001), T1b stage (all P <.001), lymph node metastasis (all P <.001), and vascular invasion (all P =.002; P =.016) as independent negative prognostic factors affecting 5-year OS and DFS in patients with early gastric cancer. Postoperative chemotherapy (P <.001; P =.019) was an independent positive prognostic factor.
Conclusion:
This real-world observational study demonstrates that lymph node metastasis in early gastric cancer is widely and disorderly not depending on the location. Therefore, systematic lymph node dissection is necessary to cure early gastric cancer. Meanwhile, its prognosis is closely related to lymph node metastasis.
