Zhou Rui, Wu Zhenzhen, Zhang Jingwen, Wang Hongqiang, Su Yuqi, Huang Na, Shi Min, Bin Jianping, Liao Yulin, Liao Wangjun
Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Department of Oncology, Zhoushan Hospital, Zhoushan 316000, China.
Oncotarget. 2016 Jan 5;7(1):1029-41. doi: 10.18632/oncotarget.6009.
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).
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.
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).
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.
准确识别远处转移性胃癌（DMGC）患者的淋巴结（LN）状态的临床后果尚不清楚。我们旨在确定N分期、阳性淋巴结（PLN）计数及阳性淋巴结比率（LNR）的预后意义。我们还回顾性比较了根据淋巴结清扫术（LND）分层的DMGC患者的生存结局。
1593例患者接受了LND。在接受LND的DMGC患者中，根据N分期、PLN及LNR分组的各亚组间癌症特异性生存（CSS）存在显著差异。较低的LNR是各类患者队列中更长生存期的独立预测因素，而PLN并非如此。PLN计数与LND数量及LNR相关。LNR与LND数量之间无相关性。接受LND及更高的清扫淋巴结数量与更好的CSS相关。
回顾了2004年至2009年间治疗的1889例DMGC患者的数据，这些数据记录在监测、流行病学和最终结果（SEER）登记处。采用Pearson相关系数和卡方检验研究LND数量、PLN计数、N分期及LNR之间的关系。采用Kaplan-Meier分析评估癌症特异性生存（CSS），采用对数秩检验进行单因素分析（UVA），采用Cox比例风险模型进行多因素分析（MVA）。
LN转移变量在DMGC患者的预后评估和治疗决策中起着重要作用。准确识别DMGC患者的LN状态至关重要。LND操作与生存率提高相关且具有临床实用性。
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