Clinicopathological features and prognostic impact of splenic hilar lymph node metastasis in proximal gastric carcinoma |
| |
| Institution: | 1. University of Groningen, University Medical Center Groningen, Department of Medical Oncology, Hanzeplein 1, 9713, GZ, Groningen, the Netherlands;2. Netherlands Cancer Institute, Antoni van Leeuwenhoek, Department of Medical Oncology, Plesmanlaan 121, 1066, CX, Amsterdam, the Netherlands;3. Netherlands Cancer Institute, Antoni van Leeuwenhoek, Department of Surgical Oncology, Plesmanlaan 121, 1066, CX, Amsterdam, the Netherlands;4. Leiden University Medical Center, Department of Medical Oncology, P.O. Box 9600, 2300, RC, Leiden, the Netherlands;5. Erasmus MC – Cancer Institute, Department of Surgical Oncology, s Gravendijkwal 230, 3015, CE, Rotterdam, the Netherlands;6. Radboud University Medical Center, Department of Medical Oncology, P.O. Box 9101, 6500, HB, Nijmegen, the Netherlands;7. Radboud University Medical Center, Department of Surgical Oncology, P.O. Box 9101, 6500, HB, Nijmegen, the Netherlands;8. University of Groningen, University Medical Center Groningen, Department of Surgical Oncology, Hanzeplein 1, 9713, GZ, Groningen, the Netherlands;1. University of Verona, Urology Department, Verona, Italy;2. Bolzano General Hospital, Bolzano, Italy;3. Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, University of Florence, Florence, Italy;4. Trieste University, Urology Department, Trieste, Italy;5. University of Genoa, Department of Urology, IRCSS San Martino – IST, Genoa, Italy;6. IRCCS-CRO, Unit of Epidemiology and Biostatistics, Aviano, Italy;7. University of Verona, Human Sciences Department, Verona, Italy;8. Department of Neurosciences, Reproductive Sciences, Odontostomatology, Urology Unit, University of Naples, Italy;9. Catholic University of Rome, Policlinico Gemelli, Urology Department, Rome, Italy;10. University of Padua, Urology Department, Padua, Italy;1. Department of Upper Gastrointestinal and Hepato-pancreato-biliary Surgery, Barretos Cancer Hospital, Barretos, SP, Brazil;2. IRCAD (Research Institute Against Cancer of the Digestive System) Latin America, Barretos, SP, Brazil;3. Department of Digestive Surgery, Escola Paulista de Medicina – UNIFESP, São Paulo, SP, Brazil |
| |
| Abstract: | BackgroundLymph nodes (LNs) at the splenic hilum (no. 10) are treated as regional LNs in proximal gastric carcinoma. However, patients with no.10 LN metastasis show a poor prognosis after curative surgery. This study aimed to investigate the prognostic impact of no.10 LN metastasis in proximal gastric carcinoma.MethodsWe retrospective reviewed 665 proximal gastric carcinoma patients who underwent total gastrectomy and D2 LN dissection. Clinicopathological features were compared between patients with and without no.10 LN metastasis. The prognostic value of no.10 LN metastasis was examined using Cox prognostic model.ResultsThere were 63 (9.5%) patients with no. 10 LN metastasis. No. 10 LN metastasis only existed in stage III/IV, and was significantly associated with greater curvature/circumferential tumor location, larger tumor size, B4 gross type, undifferentiated histology, lymphovascular invasion. The 5-year survival of no.10 LN metastasis group was 26%, which was significantly lower than those without no.10 LN metastasis (79%, p < 0.001). Patients with no. 10 LN metastasis also showed a significantly worse survival than those without in each tumor stage (stage III = 45% vs. 66%, p = 0.044, stage IV = 13% vs. 33%, p = 0.024). In the multivariate cox model, no.10 LN metastasis was an independent poor prognostic factor when adjusting for TNM stage and other prognostic factors.ConclusionThe prognosis of no.10 LN metastasis is as poor as that of distant metastasis. This suggests that no. 10 LN should rather be considered as non-regional LNs in the treatment of proximal gastric carcinoma. |
| |
| Keywords: | Gastric carcinoma Splenic hilar lymph nodes Prognosis Survival Splenectomy LN"} {"#name":"keyword" "$":{"id":"kwrd0040"} "$$":[{"#name":"text" "_":"lymph node TNM staging"} {"#name":"keyword" "$":{"id":"kwrd0050"} "$$":[{"#name":"text" "_":"tumor node metastasis staging HR"} {"#name":"keyword" "$":{"id":"kwrd0060"} "$$":[{"#name":"text" "_":"hazard ratio CI"} {"#name":"keyword" "$":{"id":"kwrd0070"} "$$":[{"#name":"text" "_":"confidence interval |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
