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Updated: Sep 17, 2025
Gene Regulation and Targeted Therapy in Gastric Cancer Peritoneal Metastasis: Radiological Findings from Dual Energy CT and PET/CT
Published on: January 22, 2018
Swollen lymph node metastasis and survival in gastric cancer: Multi-institutional post-resection analysis
Jing-Li Cui1,2, Kai Zhao3, Xiang-Li Li4
1Department of Gastrointestinal Surgery, The Affiliated Tai'an City Central Hospital of Qingdao University, Tai'an 271000, Shandong Province, China.
Background:
Gastric cancer (GC) is frequently diagnosed at advanced stages, often with lymph node metastasis (LNM), which complicates prognosis. Swollen LNM (SLNM) in GC has been linked to poor outcomes, yet its prognostic value requires validation.
Aim:
To evaluate the prognostic significance of SLNM in GC patients undergoing curative-intent gastrectomy.
Methods:
A retrospective analysis included 507 GC patients with LNM, categorized by SLNM status into positive (SLNM present) and negative (SLNM absent) groups. Survival outcomes were compared between groups, including propensity score matching and multivariate analysis to assess the role of SLNM as an independent prognostic factor.
Results:
One hundred and thirty-nine (27.4%) patients exhibited SLNM, associated with significantly lower 5-year overall survival (OS) compared to non-SLNM patients (13.6% vs 35.8%, P < 0.001). After matching, SLNM-positive patients maintained worse OS rates (13.4% vs 21.2%, P = 0.006). Multivariate analysis confirmed SLNM as an independent prognostic factor (hazard ratio = 1.318, P = 0.031). Additionally, T4 stage, N3 stage, and neoadjuvant chemotherapy independently influenced survival outcomes for SLNM-positive patients. Those who received neoadjuvant chemotherapy demonstrated better prognosis.
Conclusion:
SLNM is an independent predictor of poor prognosis in GC. Neoadjuvant chemotherapy followed by D2 gastrectomy and adjuvant chemotherapy may offer survival benefits for patients with SLNM.
