Department of General Surgery, Acibadem Mehmet Ali Aydinlar University, School of Medicine, Istanbul, Turkey.
Department of General Surgery, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey.
Medicine (Baltimore). 2023 May 19;102(20):e33757. doi: 10.1097/MD.0000000000033757.
Gastric malignancies constitute the sixth most common cancer with regards to incidence and have the fifth most mortality rates. Extended lymph-node dissection is the surgical modality of choice while treating advanced stage gastric cancer. It is yet a topic of debate, whether or not the amount of positive lymph nodes after a pathological examination following the surgical intervention is of prognostic value. In this study, it is aimed to evaluate the prognostic significance of positive lymph nodes following the surgery. A total of 193 patients who underwent curative gastrectomy between January 2011 and December 2015 have been considered for a retrospective data collection. The cases with R1-R2 resections, palliative or emergent surgeries are excluded. Metastatic to total number of lymph nodes, corresponded a ratio which was analyzed in this survey and practiced as a predictive parameter of disease outcome. This survey includes 138 male (71.5%) and 55 female (28.5%) patients treated between 2011 and 2015 in our clinic. The survey follow-up duration of the cases range between 0, 2, and 72 months, corresponding an average of 23.24 ± 16.99 months. We calculated cutoff value of 0.09 with, sensitivity is 76.32% for positive to total number of lymph nodes ratio, whereas specivity applies for 64.10%, positive predictive value for 58% and negative predictive value for 80.6%. Positive lymph node ratio has a prognostic value in terms of predicting the prognosis of the patients with gastric adenocarcinoma following a curative gastrectomy. This might in long term contribute to the prognostic analysis of patients if integrated in the current staging system.
胃恶性肿瘤的发病率居第六位，死亡率居第五位。在治疗进展期胃癌时，扩大淋巴结清扫是首选的手术方式。手术后病理检查阳性淋巴结数量是否具有预后价值仍存在争议。本研究旨在评估手术后阳性淋巴结的预后意义。共纳入 193 例 2011 年 1 月至 2015 年 12 月期间接受根治性胃切除术的患者，进行回顾性数据收集。排除 R1-R2 切除、姑息性或急诊手术的病例。将转移至淋巴结总数的比例作为预测疾病结局的参数进行分析。本研究包括 138 例男性（71.5%）和 55 例女性（28.5%）患者，均在我院接受治疗。病例的随访时间为 0、2 和 72 个月，平均为 23.24±16.99 个月。我们计算出阳性与淋巴结总数比值的截断值为 0.09，其敏感性为 76.32%，特异性为 64.10%，阳性预测值为 58%，阴性预测值为 80.6%。阳性淋巴结比值对预测接受根治性胃切除术后胃腺癌患者的预后具有一定的预后价值。如果将其纳入当前的分期系统，长期来看可能有助于患者的预后分析。
