Clinical Significance of Metastasis or Micrometastasis to the Lymph Node Along the Superior Mesenteric Vein in Gastric Carcinoma: A Retrospective Analysis

BackgroundThe validity of lymphadenectomy of the lymph node along the superior mesenteric vein (LN14v) in gastric cancer remains controversial. The study investigated the characteristics and prognosis of gastric cancer with metastasis or micrometastasis to LN14v.MethodsA retrospective study of 626 patients undergoing radical gastrectomy in our center from January 2003 to December 2015 was analyzed. In total, 303 patients had lymphadenectomy of LN14v, and lymph node micrometastasis was evaluated by immunohistochemical staining for cytokeratin nodes CK8/18. A logistic regression model was applied to confirm the predictive factors of micrometastasis. Survival analysis was performed to evaluate the effect of micrometastasis or metastasis on prognosis.ResultsThe metastatic rate of the LN14v lymph node was 15.8%, and the micrometastatic rate was 3.3%. Multivariate analysis showed site, Borrmann classification, postoperative lymph node metastasis (pN), and metastasis in LN6 and LN9 were predictive factors for LN14v micrometastasis or metastasis (P < 0.05). The 5-year survival rate in the positive group (LN14v micrometastasis or metastasis) was 12.4%. The prognosis of patients without LN14v lymph node micrometastasis was better than that of the positive group, whereas the difference between group of LN14v micrometastasis and LN14v metastasis was not obvious. In matched analysis, patients with stage III gastric cancer L/M area, pN2-3, and LN6(+) who underwent lymphadenectomy of LN14v had better survival than those without lymphadenectomy of LN14v.ConclusionLymph node micrometastasis may provide accurate prognostic information for patients with gastric cancer. Moreover, lymphadenectomy of LN14v might improve the survival of patients with stage III gastric cancer of L/M area, pN2-3, and LN6(+).

Clinical Significance of Metastasis or Micrometastasis to the Lymph Node Along Superior Mesenteric Vein in Gastric Carcinoma: a Retrospective Analysis

Background: The validity of lymphadenectomy of the lymph node along the superior mesenteric vein (LN14v) in gastric cancer remains controversial. The study investigated the characteristics and prognosis of gastric cancer with metastasis or micrometastasis to LN14v.Methods: A retrospective study of 626 patients receiving radical gastrectomy in our center from January 2003 to December 2015 was analyzed. Totally, 303 patients receiving lymphadenectomy of 14v and lymph node micrometastasis was evaluated by immunohistochemical staining for cytokeratinnodes CK8/18. Logistic regression model was applied to confirm the predictive factors of micrometastasis. Survival analysis was performed to evaluate the effect of micrometastasis or metastasis on prognosis.Results: The metastastic rate of No.14v lymph node was 15.8% and the micrometastatic rate was 3.9%. Multivariate analysis showed site, Borrmann classification, postoperative lymph node metastasis (pN), the metastasis of LN6 and LN9 were predictive factors of LN14v micrometastasis or metastaticsis (P<0.05). The 5-year survival rate of positive group (14v micrometastasis or metastasis) was 12.4%. The prognosis of patients without micrometastatic 14v lymph node was better than positive group. While the difference between group of LN14v micrometastasis and LN14v metastasis was not obvious. In matched analysis, patients with gastric cancer of stage Ⅲ, U/M area, pN2-3 and LN 6(+) underwent lymphadenectomy of 14v suffered better survival than those without lymphadenectomy of 14v. Conclusion: Lymph node micrometastasis could provide accurate prognostic information for patients with GC. Thus, lymphadenectomy of LN14v should be recommended for patients with gastric cancer of stage Ⅲ, U/M area, pN2-3 and LN 6(+).

Clinical Significance of Lymph Node Micrometastasis in pN0 Gastric Cancer Patients

Purpose. To investigate the relationship between lymph node micrometastasis (LNMM) and clinicopathological factors and to evaluate the prognostic effects of LNMM in pN0 gastric cancer (GC) patients. Methods. One hundred and seventy-two GC patients who received radical gastrectomy with D2 lymph node dissection were enrolled in the present study. 1371 negative lymph nodes from level 2 station confirmed by pathology were examined. The LNMM was diagnosed by telomeric repeat amplification protocol/enzyme-linked immunosorbent assay (TRAP-ELISA). The relationship between clinicopathological factors and LNMM was investigated by multivariate analysis. Survival analysis was performed to evaluate the effects of LNMM on prognosis. Results. LNMM was detected in 423 lymph nodes from 72 patients. The results showed that invasion depth ( OR = 3.755 , P = 0.004 ), TNM staging ( OR = 3.152 , P = 0.002 ), lymphatic invasion ( OR = 2.178 , P = 0.009 ), and tumor differentiation ( OR = 1.266 , P = 0.013 ) were independent risk factors associated with LNMM. Survival analysis showed that patients with LNMM had significantly worse 5-year survival compared with those without LNMM (42% vs. 76.4%, P < 0.05 ). Multivariate analysis demonstrated that LNMM, tumor size, Lauren type, invasion depth, and lymphatic invasion ( P < 0.05 ) were independently factors associated with 5-year survival. Conclusions. The findings showed that tumor invasion depth, TNM staging, lymphatic invasion, and tumor differentiation were independent risk factors associated with LNMM occurrence. Moreover, LNMM is a clinically negative prognostic factor in pN0 GC patients.