|Table of Contents|

The value of metastatic lymph node ratio in 347 patients with T3 gastric cancer

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2019 01
Page:
87-91
Research Field:
Publishing date:

Info

Title:
The value of metastatic lymph node ratio in 347 patients with T3 gastric cancer
Author(s):
Li Fengke; Song Shubin; Xue Yingwei
Cancer Hospital，Harbin Medical University，Heilongjiang Harbin 150081，China.
Keywords:
gastric cancer; T3; metastatic lymph node ratio; prognosis
PACS:
R735.2
DOI:
10.3969/j.issn.1672-4992.2019.01.022
Abstract:
Objective：To make certain the influencing factors of metastatic lymph node ratio and its' clinical significance in patients with T3 gastric cnacer. Methods：The clinicopathological data of 347 patients with T3 gastric cancer who were underwent surgery were retrospectively analyzed in Harbin Medical University Cancer Hospital from January 2007 to December 2010.The relationships between lymph nodes metastasis ratio and related clinicopathologic factors were analyzed by Chi-square test and Logistic regression analysis.Survival analysis was analyzed by Kaplan-Meier method and Log-rank test compare the survival rate difference between the two groups.The prognosis were analyzed by Cox proportional hazards regression model.Results：Chi-square test showed that：Compared with the MLN≤28.66%'s group，the MLN>28.66%'s histological type was more worse［93.3%(127/136) vs 76.8%(162/211)，P=0.000］，higher proportion of tumours in total stomach［12.5%(17/136) vs 3.8%(8/211)，P=0.002］，tumor diameter was larger［49.3%(67/136) vs 27.5%(58/211)，P=0.000］，high serum CEA level［33.1%(45/136) vs 22.7%(48/211)，P=0.034］，easily happened distant metastasis［11.0%(15/136) vs 2.4%(5/211)，P=0.001］.Logistic regression analysis showed that：Tumor location(total gastric)，tumor diameter(>6.1 cm),differentation type(poor)，serum CEA level(>5 ng/ml),serum albumin level(≤40 g/L) were risk factors leading to high rates of metastatic lymph node ratio.During the follow-up，there were 233(67.1%) cases died of tumor progression in the gastric stump cancer's group and the 5-year survival rate was 33.1%.Univariate analysis showed that the patients had a better prognosis：Age≤60 years old，radical operation,tumor location(fundus/body/antrum)，LNR≤28.66%，M0，tumor diameter ≤6.1 cm，CA19-9≤37 U/ml(all P<0.05)，but the number of lymph node dissection not influenced the prognosis of patients(P=0.089).Multivariate analysis showed that：Age［HR(95%CI)：1.487(1.139~1.941)，P=0.004］，surgery［HR(95%CI)：1.741(1.205~2.515)，P=0.003］，MLNR［HR(95%CI)：3.053(2.293~4.065)，P=0.000］，M0/M1［HR(95%CI)：1.766(1.043~2.991)，P=0.034］ were independent risk factors of the patients with T3 gastric cancer.Conclusion：Metastatic lymph node ratio was independent risk factors for prognosis in patients with T3 gastric cancer and there were correlation betwween metastatic lymph node and ratiohistological type，tumor diameter，tumor location，serum CEA concentration，distant metastasis.We can assess the ratio of lymph nodes metastasis of patients by some indexes，so that we can evaluate the prognosis of patients with T3 gastric cancer.

References:

[1]Chen Wanqing.Cancer statistics in China，2015［J］.CA Cancer J Clin，2016，66：115-132.
[2]Rebecca L，Siegel MPH. Cancer Statistics 2016［J］.CA Cancer J Clin，2016，66：7-30.
[3]Ferlay J，Soerjomataram I，Dikshit R，et al.Cancer incidence and mortality worldwide：Sources，methods and major patterns in G，pbpcan 2012［J］.Int J Cancer，2015，136(5)：E359-386.
[4]Zhang Qiting，Zheng Jie，Jiang Longwei，et al.Clinical research progress of immunotherapy combine with chemotherapy for gastric cancer［J］.Modern Oncology，2018，26(2)：302-306.［张启婷，郑劼，江龙委，等.胃癌免疫治疗联合化疗的临床研究进展［J］.现代肿瘤医学，2018，26(2)：302-306.］
[5]Li Minghui，Liu Hongbo，Feng Yunzhang.Efficacy of Kanglaite CHPP combined with XELOX chemotherapy on patients with pro-gressive gastric cancer［J］.Modern Oncology，2017，25(2)：266-269.［李明辉，刘红波，冯运章.康莱特腹腔热灌注联合 XELOX 方案化疗治疗进展期胃癌的疗效观察［J］.现代肿瘤医学，2017，25(2)：266-269.］
[6]Kawaguchi T，Komatsu S，Ichikawa D，et al.Clinical significance and prognostic impact of the total diameter of enlarged lymph nodes on preoperative multidetector computed tomography in patients with gastric cancer［J］.J Gastroenterol Hepatol，2015，30(11)：1603-1609.
[7]Zhou Y，Yu F，Wu L，et al.Survival after gastrectomy in node-negative gastric cancer：A review and Meta-analysis of prognostic factors［J］.Medical Science Monitor，2015，21：1911.
[8]Maezawa Y，Aoyama T，Yamada T，et al.Priority of lymph node dissection for proximal gastric cancer invading the greater curvature［J］.Gastric Cancer，2017，11:8.
[9]Sano T，Hollwood A.Early gastric cancer:Diagnosis and less invasive treatments［J］.Scand J Surg，2006，95(4)：249-255.
[10]Kim Y，Squires MH，Poultsides GA，et al.Impact of lymph node ratio in selecting patients with resected gastric cancer for adjuvant therapy［J］.Surgery，2017，162(2)：285-294.
[11]Juca PC，Lourenco L，Kesley R，et al. Comparison of survival and prognostic factors in patients with gastric adenocarcinoma in T2 and T3［J］.Rev Col Brass Cir，2012，39(5)：377-384.
[12]Hu X.New treatment modalities for Japanese gastric cancer treatment guidelines and classification［J］.Chinese Journal of Practical Surgery，2016，36(6)：648-651.［胡祥.日本《胃癌处理公约》及《胃癌治疗指南》变更的新动态［J］.中国实用外科杂志，2016，36(6)：648-651.］
[13]Sakurai K，Ohira M，Tamura T，et al.Predictive potential of preoperative nutritional status in long-term outcome projections for patients with gastric cancer［J］.Ann Surg Oncol，2016，23(2)：525-533.
[14]Nie R，Yuan S，Chen S，et al.Prognostic nutritional index is an independent prognostic factor for gastric cancer patients with peritoneal dissemination［J］.Chin J Cancer Res，2016，28(6)：570-578.
[15]Liang Jing，Guo Junjun，Yang Yiping，et al.Prognostic value of serum albumin level in re-irradiation for patients with local recurrent esophageal carcinoma［J］.Modern Oncology，2017，25(20)：3249-3251.［梁晶，郭俊俊，杨怡萍，等.血清白蛋白水平与食管癌再程放疗预后关系的研究［J］.现代肿瘤医学，2017，25(20)：3249-3251.］
[16]Huang YS，Chang SC，Liu KH，et al.A prognostic model based on lymph node metastatic ratio for predicting survival outcome in gastric cancer patients with N3b subclassification［J］.Asian J Surg，2017，10:1-8.
[17]Bausys A，Klimas D，Kilius A，et al.Tumor differentiation is a risk factor for lymph node metastasis in patients with gastric cancer［J］.Ann Oncol，2015，26(suppl 4)：iv28.
[18]Lai JF，Xu WN，Noh SH，et al.Effect of world health organization(WHO) histological classification on predicting lymph node metastasis and recurrence in early gastric cancer［J］.Med Sci Monit，2016，22：3147-3153.
[19]Guo J，Chen S，Li S，et al.A novel classifier based on three preoperative tumor markers predicting the cancer-specific survival of gastric cancer(CEA，CA19-9 and CA72-4)［J］.Oncotarget，2017，9(4)：4814-4822.
[20]He B，Zhang HQ，Xiong SP，et al.Changing patterns of Serum CEA and CA199 for evaluating the response to first-line chemotherapy in patients with advanced gastric adenocarcinoma［J］. Asian Pac J cancer Prey，2015，16(8)：3111-31116.
[21]Wang Yang，Wang Huan，Mo Jiamei，et al.The value of serum tumor marker in gastric cancer diagnosis［J］.Modern Oncology，2014，22(4)：883-885.［王洋，王欢，莫佳美，等.血清肿瘤标志物在胃癌诊断中的价值［J］.现代肿瘤医学，2014，22(4)：883-885.］
[22]Sun H，He B，Nie Z，et al.A nomogram based on serum bilirubin and albumin levels predicts survival in gastric cancer patients［J］.Oncotarget，2017，8(25)：41305-41318.
[23]Kilic M，Gundodu SB，zden S，et al.The prognostic value of different node staging systems in patients with ≤15 lymph nodes following surgery for gastric adenocarcinoma［J］.Acta Chir Belg，2018，118(1)：1-6.
[24]Lee JH，Kang JW，Nam BH，et al.Correlation between lymph node count and survival and a reappraisal of lymph node ratio as a predictor of survival in gastric cancer：A multi-institutional cohort study［J］.Eur J Surg Oncol，2017，43(2)：432-439.
[25]Takahashi M，Takeuchi H，Tsuwano S，et al.Surgical resection of remnant gastric cancer following distal gastrectomy：A retrospective clinicopathological study［J］.Ann Surg Oncol，2016，23(2)：511-521.
[26]Han Xiaopeng，Li Sandang，Jing Huazhong，et al.Application of tumor-free technique in laparoscopic gastrectomy with D2 lymph nodes dissection［J］.Modern Oncology，2015，23(4)：509-511.［韩晓鹏，李三党，景化忠，等.腹腔镜胃癌D2根治术中无瘤技术的应用［J］.现代肿瘤医学，2015，23(4)：509-511.］
[27]Song S，Li C，Li S，et al.Clinicopathological features and prognoses in younger and older patients with gastric cancer［J］.Onco Targets Ther，2017，10：4795-4802.
[28]Liu L，Hao H，Zhao L，et al.Analysis of survival and prognosis of 298 gastric adenocarcinoma patients with no distant metastasis［J］.Oncol Lett，2017，14(6)：7813-7816.

Memo

Memo:
黑龙江省自然科学基金重点项目（编号：ZD201019）；哈尔滨市科技局应用技术研究与开发项目(编号：2017RAXXJ054)；哈尔滨医科大学附属肿瘤医院资助项目（编号：Nn10PY2017-3）
Last Update: 2018-11-30