General and Emergency Surgery, Santa Maria della Misericordia Hospital - University of Perugia, Perugia, Italy.
General and Emergency Surgery, Santa Maria della Misericordia Hospital - University of Perugia, Perugia, Italy
In Vivo. 2024 Sep-Oct;38(5):2410-2414. doi: 10.21873/invivo.13709.
BACKGROUND/AIM: To date, the different clinicopathological characteristics of gastric cancer (GC) in the lesser curvature and greater curvature remain unclear. The aim of this study was to investigate the different features of the tumors in the two sites and provide new strategy for a tailored therapy.
Between January 2003 and December 2019, 121 patients with GC located in the lesser or greater curvature were surgically treated with curative intent. Data about clinico-pathological features were retrospectively analyzed. In addition, we analyzed the different lymph node patterns according to the lymph node (LN) metastasis between the two groups of patients.
No statistically significant differences were found regarding the 5-year overall survival (5y-OS) and 5y disease-free survival (5y-DFS) between patients with GC in the two sites (p=0.94 and p=0.98, respectively). Considering TNM pathological stage, patients with GC in the lesser curvature in stage II and III, showed a worse survival than those with GC in the greater curvature (stage II 5y-OS: 80 vs. 100% and stage III 5y-OS: 18.9 vs. 55.5%). Considering the median value of metastasis LNs, GC in the greater curvature metastasized more often to LN stations no. 8, 10, and 11, whereas GC in the lesser curvature to LN stations no. 8, 9, and 12.
GC in the lesser curvature showed a worse prognosis than GC in the greater curvature. Therefore, GC in the lesser curvature could undergo a more aggressive surgery, including an extended lymphadenectomy, and a close follow-up.
背景/目的：迄今为止，胃（GC）在小弯和大弯处的不同临床病理特征仍不清楚。本研究旨在探讨这两个部位肿瘤的不同特征，并为针对性治疗提供新策略。
2003 年 1 月至 2019 年 12 月，121 例有根治性手术治疗的小弯或大弯 GC 患者，回顾性分析其临床病理特征。此外，我们还根据两组患者的淋巴结转移情况，分析了不同的淋巴结（LN）分布模式。
两组患者的 5 年总生存率（5y-OS）和 5 年无病生存率（5y-DFS）无统计学差异（p=0.94 和 p=0.98）。考虑 TNM 病理分期，小弯 GC 在 II 期和 III 期患者的生存情况较大弯 GC 差（II 期 5y-OS：80%比 100%和 III 期 5y-OS：18.9%比 55.5%）。考虑转移 LN 的中位数，大弯 GC 更多地转移到 LN 站 no.8、10 和 11，而小弯 GC 更多地转移到 LN 站 no.8、9 和 12。
小弯 GC 的预后较大弯 GC 差。因此，小弯 GC 可采用更积极的手术方式，包括扩大淋巴结清扫术和密切随访。
