Department of Surgical Oncology, Sakarya University Training and Research Hospital, Sakarya, Turkey.
Department of Pathology, Sakarya University Training and Research Hospital, Sakarya, Turkey.
Langenbecks Arch Surg. 2023 Jun 26;408(1):247. doi: 10.1007/s00423-023-02996-0.
The number of lymph nodes is used to determine the prognosis in patients with gastric cancer undergoing D2 lymph node dissection. However, a group of extraperigastric lymph nodes, including lymph node 8a, are also considered to be effective in prognosis. In our clinical experience, in most patients during D2 lymph node dissection, the lymph nodes are removed en-bloc with the specimen and are not marked separately. The aim was to analyze the importance and prognostic impact of 8a lymph node metastasis in patients with gastric cancer.
Patients who underwent gastrectomy and D2 lymph node dissection for gastric cancer between 2015 and 2022 were included in the study. Patients were divided into two groups based on metastasis to the 8a lymph node: metastatic and nonmetastatic. The effect of clinicopathologic features and the prevalence of lymph node metastasis on the prognosis of the two groups were analyzed.
The present study included 78 patients. The mean number of dissected lymph nodes was 27 (IQR, 15-62). There were 22 (28.2%) patients in the 8a lymph node metastatic group. Patients with 8a lymph node metastatic disease had shorter overall survival and shorter disease-free survival. Those with metastatic 8a lymph nodes among pathologic N2/3 patients had shorter overall and disease-free survival rates (p < 0.05).
In conclusion, we believe that anterior common hepatic artery (8a) LN metastasis is a key factor that negatively affects both disease-free and overall survival in patients with locally advanced gastric cancer.
淋巴结数量用于确定接受 D2 淋巴结清扫术的胃癌患者的预后。然而，一组胃外淋巴结，包括淋巴结 8a，也被认为对预后有效。在我们的临床经验中，在大多数接受 D2 淋巴结清扫术的患者中，淋巴结与标本一起整块切除，而不单独标记。目的是分析胃癌患者 8a 淋巴结转移的重要性和预后影响。
纳入 2015 年至 2022 年间接受胃癌根治性胃切除术和 D2 淋巴结清扫术的患者。根据 8a 淋巴结转移情况将患者分为转移组和非转移组。分析两组临床病理特征和淋巴结转移的发生率对预后的影响。
本研究共纳入 78 例患者。淋巴结清扫的平均数量为 27 个（IQR，15-62）。有 22 例（28.2%）患者 8a 淋巴结转移。8a 淋巴结转移的患者总生存率和无病生存率更短。在病理 N2/3 患者中，有 8a 淋巴结转移的患者总生存率和无病生存率更短（p<0.05）。
总之，我们认为肝总动脉前侧（8a）淋巴结转移是影响局部进展期胃癌患者无病和总生存的关键因素。
