Clinical Research Papers:

Clinical significance of accurate identification of lymph node status in distant metastatic gastric cancer

Rui Zhou, Zhenzhen Wu, Jingwen Zhang, Hongqiang Wang, Yuqi Su, Na Huang, Min Shi, Jianping Bin, Yulin Liao and Wangjun Liao _

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Oncotarget. 2016; 7:1029-1041. https://doi.org/10.18632/oncotarget.6009

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Rui Zhou1,*, Zhenzhen Wu1,*, Jingwen Zhang1, Hongqiang Wang1,2, Yuqi Su1,3, Na Huang1, Min Shi1, Jianping Bin4, Yulin Liao4, Wangjun Liao1

1Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China

2Department of Oncology, Zhoushan Hospital, Zhoushan 316000, China

3Department of Oncology, The First People's Hospital of Yueyang, Yueyang 414000, China

4Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China

*These authors have contributed equally to this work

Correspondence to:

Wangjun Liao, e-mail: [email protected]

Keywords: lymph node status, palliative surgery, LND, distant metastatic gastric cancer, survival

Received: August 14, 2015     Accepted: October 09, 2015     Published: October 19, 2015


PURPOSE: The clinical consequences of accurately identifying lymph node (LN) status in distant metastatic gastric cancer (DMGC) are unclear. We aimed to determine the prognostic significance of N stage, positive LN (PLN) count, and the positive LN ratio (LNR). We also retrospectively compared survival outcomes of DMGC patients stratified by LN dissection (LND).

RESULTS: LND was performed in 1593 patients. The CSS was significantly different between groups divided according to N stage, PLN, and LNR in DMGC patients who underwent LND. Lower LNR was an independent predictor of longer survival in all kinds of patients cohorts, whereas PLN was not such a predictor. PLN count correlated with LND number and LNR. No correlation existed between LNR and LND number. Undergoing LND and having a higher number of dissected LNs were associated with superior CSS.

MATERIALS AND METHODS: Data from 1889 DMGC patients treated between 2004 and 2009, and documented in the Surveillance, Epidemiology, and End Results (SEER) registry, were reviewed. Pearson's correlation coefficient and the Chi-square test were used to study the relationships between LND number, PLN count, N stage, and the LNR. Cancer-specific survival (CSS) was evaluated using Kaplan-Meier analysis, with the log-rank test performed for univariate analysis (UVA) and the Cox proportional hazards model employed for multivariate analysis (MVA).

CONCLUSION: LN metastatic variables play important roles in the prognostic evaluation and treatment decisions of DMGC patients. Accurate identification of LN status in DMGC patients is critical. LND performance is associated with increased survival and has clinical practicability.

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