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Tian Y, Pang Y, Yang PG, Guo HH, Liu Y, Zhang Z, Ding PA, Zheng T, Li Y, Fan LQ, Zhang ZD, Wang D, Zhao XF, Tan BB, Liu Y, Zhao Q. Clinical implications of micro lymph node metastasis for patients with gastric cancer. BMC Cancer 2023; 23:536. [PMID: 37308852 DOI: 10.1186/s12885-023-11023-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 05/29/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Lymph node size is considered as a criterion for possible lymph node metastasis in imageology. Micro lymph nodes are easily overlooked by surgeons and pathologists. This study investigated the influencing factors and prognosis of micro lymph node metastasis in gastric cancer. METHODS 191 eligible gastric cancer patients who underwent D2 lymphadenectomy from June 2016 to June 2017 in the Third Surgery Department at the Fourth Hospital of Hebei Medical University were retrospectively analyzed. Specimens were resected en bloc and the postoperative retrieval of micro lymph nodes was carried out by the operating surgeon for each lymph node station. Micro lymph nodes were submitted for pathological examination separately. According to the results of pathological results, patients were divided into the "micro-LNM (micro lymph node metastasis)" group (N = 85) and the "non micro-LNM" group (N = 106). RESULTS The total number of lymph nodes retrieved was 10,954, of which 2998 (27.37%) were micro lymph nodes. A total of 85 (44.50%) gastric cancer patients had been proven to have micro lymph node metastasis. The mean number of micro lymph nodes retrieved was 15.7. The rate of micro lymph node metastasis was 8.1% (242/2998). Undifferentiated carcinoma (90.6% vs. 56.6%, P = 0.034) and more advanced Pathological N category (P < 0.001) were significantly related to micro lymph node metastasis. The patients with micro lymph node metastasis had a poor prognosis (HR for OS of 2.199, 95% CI = 1.335-3.622, P = 0.002). For the stage III patients, micro lymph node metastasis was associated with shorter 5-year OS (15.6% vs. 43.6%, P = 0.0004). CONCLUSIONS Micro lymph node metastasis is an independent risk factor for poor prognosis in gastric cancer patients. Micro lymph node metastasis appears to be a supplement to N category in order to obtain more accurate pathological staging.
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Affiliation(s)
- Yuan Tian
- Third Surgery Department, the Fourth Hospital of Hebei Medical University, No.12, Jian-Kang Road, Shijiazhuang, 050011, Hebei Province, China
| | - Yue Pang
- Third Surgery Department, the Fourth Hospital of Hebei Medical University, No.12, Jian-Kang Road, Shijiazhuang, 050011, Hebei Province, China
| | - Pei-Gang Yang
- Third Surgery Department, the Fourth Hospital of Hebei Medical University, No.12, Jian-Kang Road, Shijiazhuang, 050011, Hebei Province, China
| | - Hong-Hai Guo
- Third Surgery Department, the Fourth Hospital of Hebei Medical University, No.12, Jian-Kang Road, Shijiazhuang, 050011, Hebei Province, China
| | - Yang Liu
- Third Surgery Department, the Fourth Hospital of Hebei Medical University, No.12, Jian-Kang Road, Shijiazhuang, 050011, Hebei Province, China
| | - Ze Zhang
- Third Surgery Department, the Fourth Hospital of Hebei Medical University, No.12, Jian-Kang Road, Shijiazhuang, 050011, Hebei Province, China
| | - Ping-An Ding
- Third Surgery Department, the Fourth Hospital of Hebei Medical University, No.12, Jian-Kang Road, Shijiazhuang, 050011, Hebei Province, China
| | - Tao Zheng
- Third Surgery Department, the Fourth Hospital of Hebei Medical University, No.12, Jian-Kang Road, Shijiazhuang, 050011, Hebei Province, China
| | - Yong Li
- Third Surgery Department, the Fourth Hospital of Hebei Medical University, No.12, Jian-Kang Road, Shijiazhuang, 050011, Hebei Province, China
| | - Li-Qiao Fan
- Third Surgery Department, the Fourth Hospital of Hebei Medical University, No.12, Jian-Kang Road, Shijiazhuang, 050011, Hebei Province, China
| | - Zhi-Dong Zhang
- Third Surgery Department, the Fourth Hospital of Hebei Medical University, No.12, Jian-Kang Road, Shijiazhuang, 050011, Hebei Province, China
| | - Dong Wang
- Third Surgery Department, the Fourth Hospital of Hebei Medical University, No.12, Jian-Kang Road, Shijiazhuang, 050011, Hebei Province, China
| | - Xue-Feng Zhao
- Third Surgery Department, the Fourth Hospital of Hebei Medical University, No.12, Jian-Kang Road, Shijiazhuang, 050011, Hebei Province, China
| | - Bi-Bo Tan
- Third Surgery Department, the Fourth Hospital of Hebei Medical University, No.12, Jian-Kang Road, Shijiazhuang, 050011, Hebei Province, China
| | - Yu Liu
- Third Surgery Department, the Fourth Hospital of Hebei Medical University, No.12, Jian-Kang Road, Shijiazhuang, 050011, Hebei Province, China
| | - Qun Zhao
- Third Surgery Department, the Fourth Hospital of Hebei Medical University, No.12, Jian-Kang Road, Shijiazhuang, 050011, Hebei Province, China.
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