Nishimuta Masato, Arai Junichi, Hamasaki Keiko, Hashimoto Yasumasa, Nonaka Takashi, Tominaga Tetsuro, Oyama Shosaburo, Yasutake Toru, Sawai Terumitsu, Nagayasu Takeshi
Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan.
Cancer Diagn Progn. 2022 Sep 3;2(5):558-563. doi: 10.21873/cdp.10142. eCollection 2022 Sep-Oct.
BACKGROUND/AIM: Japanese Gastric Cancer Treatment Guidelines do not recommend adjuvant chemotherapy after radical gastrectomy for pathological stage (p) T1N+ or pT2~3N0 gastric cancer. However, some patients experience disease recurrence. This study aimed to identify the risk factors for recurrence in pT1N+ or pT2-3N0 gastric cancer.
The study included 157 patients with diagnosed pT1N+ or pT2-3N0 gastric cancer who underwent radical gastrectomy at our institution between January 2001 and December 2020. Clinicopathological data and surgical data were obtained. Independent prognostic factors were analyzed using a Cox proportional hazards regression model.
Thirteen patients (8.3%) experienced disease recurrence. Multivariate analysis revealed that the number of examined lymph nodes was an independent prognostic factor for recurrence-free survival (hazard ratio=10.90; 95% confidence interval=1.39-85.86; p=0.023). The group with ≤35 examined lymph nodes had significantly worse recurrence-free survival compared with the group with ≥36 examined lymph nodes (80.7% versus 98.7%; p=0.0005).
The number of examined lymph nodes (≤35) was an independent risk factor for recurrence after radical gastrectomy with pT1N+ or pT2-3N0 gastric cancer.
背景/目的：日本胃癌治疗指南不推荐对病理分期为（p）T1N+或pT2~3N0的胃癌患者在根治性胃切除术后进行辅助化疗。然而，一些患者会出现疾病复发。本研究旨在确定pT1N+或pT2-3N0胃癌复发的危险因素。
本研究纳入了2001年1月至2020年12月期间在我院接受根治性胃切除术的157例诊断为pT1N+或pT2-3N0胃癌的患者。获取了临床病理数据和手术数据。使用Cox比例风险回归模型分析独立预后因素。
13例患者（8.3%）出现疾病复发。多因素分析显示，检查淋巴结数量是无复发生存的独立预后因素（风险比=10.90；95%置信区间=1.39-85.86；p=0.023）。检查淋巴结数量≤35个的组与检查淋巴结数量≥36个的组相比，无复发生存率显著更差（80.7%对98.7%；p=0.0005）。
检查淋巴结数量（≤35个）是pT1N+或pT2-3N0胃癌根治性胃切除术后复发的独立危险因素。
