ASO Author Reflections: Effect of Noncompliance in Lymph Node Dissection on the Long-Term Survival of Gastric Cancer Patients After Radical Gastrectomy

Introduction. The impact of preoperative BMI on surgical outcomes and long-term survival of gastric cancer patients was investigated in various reports with contrasting results.Materials & Methods. A total of 378 patients who underwent a surgical resection for primary gastric cancer between 1994 and 2011 were retrospectively studied. Patients were stratified according to BMI into a normal group (<25, group A), an overweight group (25–30, group B), and an obesity group (≥30, group C). These 3 groups were compared according to clinical-pathological characteristics, surgical treatment, and long-term survival.Results. No significant correlations between BMI and TNM (2010), UICC stage (2010), Lauren’s histological type, surgical results, lymph node dissection, and postoperative morbidity and mortality were observed. Factors related to higher BMI were male genderP<0.05, diabetesP<0.001, and serum blood proteinsP<0.01. A trend to fewer lymph nodes retrieved during gastrectomy with lymphadenectomy in overweight patients (B and C groups) was observed, although not statistically significant. There was no difference in overall survival or disease-specific survival between the three groups.Conclusion. According to our data, BMI should not be considered a significant predictor of postoperative complications or long-term result in gastric cancer patients.

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Outcome of Gastric Cancer Patients Submitted to D1 Lymph Node Dissection Due to Unfavorable Medical Conditions

Gastroenterology ◽

10.1016/s0016-5085(17)34151-3 ◽

2017 ◽

Vol 152 (5) ◽

pp. S1247

Author(s):

Marcus Kodama Ramos ◽

Marina Pereira ◽

André R. Dias ◽

Osmar K. Yagi ◽

Leandro C. Barchi ◽

...

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Cancer Patients ◽

Lymph Node Dissection ◽

Medical Conditions ◽

Node Dissection ◽

Gastric Cancer Patients

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Application value of nomogram and prognostic factors of gastric cancer patients who underwent D2 radical lymphadenectomy

BMC Gastroenterology ◽

10.1186/s12876-019-1098-6 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Guang-Chuan Mu ◽

Yuan Huang ◽

Zhi-Ming Liu ◽

Xiang-Hua Wu ◽

Xin-Gan Qin ◽

...

Keyword(s):

Gastric Cancer ◽

Regression Analysis ◽

Prognostic Factors ◽

Cancer Patients ◽

Cox Regression ◽

Term Survival ◽

Long Term Survival ◽

Cox Regression Analysis ◽

Gastric Cancer Patients

Abstract Background The aim of this study was to explore the prognostic factors and establish a nomogram to predict the long-term survival of gastric cancer patients. Methods The clinicopathological data of 421 gastric cancer patients, who were treated with radical D2 lymphadenectomy by the same surgical team between January 2009 and March 2017, were collected. The analysis of long-term survival was performed using Cox regression analysis. Based on the multivariate analysis results, a prognostic nomogram was formulated to predict the 5-year survival rate probability. Results In the present study, the total overall 3-year and 5-year survival rates were 58.7 and 45.8%, respectively. The results of the univariate Cox regression analysis revealed that tumor staging, tumor location, Borrmann type, the number of lymph nodes dissected, the number of lymph node metastases, positive lymph nodes ratio, lymphocyte count, serum albumin, CEA, CA153, CA199, BMI, tumor size, nerve invasion, and vascular invasion were prognostic factors for gastric cancer (all, P < 0.05). However, merely tumor staging, tumor location, positive lymph node ratio, CA199, BMI, tumor size, nerve invasion, and vascular invasion were independent risk factors, based on the results of the multivariate Cox regression analysis (all, P < 0.05). The nomogram based on eight independent prognostic factors revealed a well-degree of differentiation with a concordance index of 0.76 (95% CI: 0.72–0.79, P < 0.001), which was better than the AJCC-7 staging system (concordance index = 0.68). Conclusion The present study established a nomogram based on eight independent prognostic factors to predict long-term survival in gastric cancer patients. The nomogram would be beneficial for more accurately predicting the prognosis of gastric cancer, and provide important basis for making individualized treatment plans following surgery.

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