A simple classification of lymph node level in gastric carcinoma

Area of Science:

• Oncology
• Surgical Pathology
• Gastrointestinal Cancer Research

Background:

• Accurate lymph node examination is crucial for staging gastric carcinoma and avoiding stage migration.
• Insufficient lymph node analysis can lead to misclassification of early-stage gastric cancer.
• Evaluating surgical outcomes requires precise assessment of dissected lymph nodes.

Purpose of the Study:

• To develop a simple and effective classification system for lymph node levels in gastric carcinoma.
• To analyze the frequency and distribution of lymph node metastasis in curatively treated, node-positive gastric cancer patients.
• To establish a reliable method for predicting surgical results based on lymph node status.

Main Methods:

• Analysis of clinicopathologic data from 240 patients with curatively resected node-positive gastric carcinoma.
• Classification of patients into three groups based on positive lymph node levels: Level I (perigastric), Level II (intermediate), and Level III (distant).
• Correlation of lymph node metastasis degree with survival rates and clinicopathologic factors.

Main Results:

• Lymph node level significantly correlated with patient survival: 5-year survival rates were 67% (Level I), 35% (Level II), and 26% (Level III) (P < 0.01).
• The extent of lymph node metastasis was influenced by the number of positive nodes, depth of invasion, tumor size, and tumor location.
• Statistical significance (P < 0.01) was observed for the number of positive nodes, invasion depth, and tumor size, and (P < 0.05) for tumor location.

Conclusions:

• A straightforward classification of lymph node levels (I, II, and III) is valuable for assessing and predicting surgical outcomes in gastric carcinoma.
• This classification system enhances the accuracy of staging and prognosis for gastric cancer patients.
• The proposed lymph node level system offers a practical tool for oncologists and surgeons.