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Impact of solitary lymph node metastasis on the prognosis of gastric cancer

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Author:
No author available
Journal Title:
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
Issue:
3
DOI:
10.3760/cma.j.issn.1671-0274.2010.03.007
Key Word:
胃肿瘤;淋巴结转移,孤立;胃切除术,D_2;预后;Stomach neoplasms;Lymph node metastasis;Lymphadenectomy;Survival rate

Abstract: Objective To investigate the impact of solitary lymph node (LN) metastasis on the prognosis of gastric cancer. Methods Clinical data of 280 patients with gastric cancer who underwent D_2 radical resection from January 1995 to December 2003 were analyzed retrospectively. Among them,solitary LN metastasis was proven pathologically in 83 cases(solitary LN metastasis group), while node-negative metastasis proven in 197 cases (node-negative group). The 5-year survival rate was compared between two groups and between patients with and without skipping LN metastasis. The prognostic factors were evaluated by univaria and muhivaria analyses. Results The 5-year survival rates in the solitary LN metastasis group and the node-negative group were 62.3% and 83.5% respectively with significant difference (P<0.05). The solitary LN metastasis was one of the independent prognostic factors, logistic regression revealed that the invasion depth was an independent covariate for solitary LN metastasis. The proportion of skip metastasis was 22.9% in gastric cancer patients with solitary LN metastasis. The 5-year survival rates of the patients with and without skipping LN metastasis were 50.0% and 66.1% respectively, which was not significantly different (P>0.05). Conclusions The prognosis of patients with solitary LN metastasis is significantly poorer than those without lymph node metastasis. Due to the high incidence of skip LN metastasis in gastric cancer, D_2 radical resection should be performed to ensure ontological clearance.

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