Retrieved Lymph Node Number Affects Gastric Cancer Prognosis

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In patients with pathological stage (pStage) II or III gastric cancer, the number of retrieved lymph nodes (RLNs) is an independent poor prognostic factor.
In patients with pathological stage (pStage) II or III gastric cancer, the number of retrieved lymph nodes (RLNs) is an independent poor prognostic factor.

(HealthDay News) -- In patients with pathological stage (pStage) II or III gastric cancer, the number of retrieved lymph nodes (RLNs) is an independent poor prognostic factor, according to a study published in the Journal of Gastroenterology and Hepatology.

Wataru Okajima, from the Kyoto Prefectural University of Medicine in Japan, and colleagues retrospectively analyzed 1,289 consecutive gastric cancer patients who underwent gastrectomy between 1997 and 2011. The patients were divided into two groups with a cut-off RLN number of 16.

The researchers found that survival rates differed significantly for patients in pStage II (P < 0.0001) and III (P = 0.0009), but not for patients in pStage I (P = 0.0627) and IV (P = 0.1553). For 498 patients in pStage II and III, patients in the RLN <16 group had a significantly higher incidence in older age and positive lymph node ratio compared with patients in the RLN ≥16 group.

An RLN number <16 was an independent poor prognostic factor (hazard ratio, 2.48; P < 0.0001) in univariate and multivariate analysis. In pStage II or III patients, a cut-off RLN of 16 could cause the stage migration effect. The prognostic effect could be eliminated by a cut-off RLN of 25 or more.

"The RLN number may potentially affect the prognosis and the stage migration in pStage II or III gastric cancer patients," the authors write.

Reference

  1. Okajima W, Komatsu S, Ichikawa D, et al. Prognostic impact of the number of retrieved lymph nodes in patients with gastric cancer. JGHF. 2016 Sep 25. doi: 10.1111/jgh.13306. [Epub ahead of print.]

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