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Metastasis, Risk Factors and Prognostic Significance of Splenic Hilar Lymph Nodes in Gastric Adenocarcinoma
- Source :
- PLoS ONE, PLoS ONE, Vol 9, Iss 6, p e99650 (2014)
- Publication Year :
- 2014
- Publisher :
- Public Library of Science (PLoS), 2014.
-
Abstract
- BACKGROUND: The metastatic rate and risk factors of splenic hilar (No.10) lymph nodes (LNs) in gastric adenocarcinoma were still variable and uncertain, and the prognostic significance of No.10 LNs was also controversial. The aim of this retrospective study was to analyze the metastatic rate, risk factors and prognostic significance of No.10 LNs in gastric adenocarcinoma. METHODS: From August 2007 to December 2011, 205 patients who were diagnosed with primary gastric adenocarcinoma and underwent total or proximal gastrectomy plus No.10 LNs dissection in West China Hospital were enrolled. Clinicopathological features and survival outcomes were retrospectively analyzed. RESULTS: Mean numbers of harvested LNs and metastatic LNs were 34.8±12.6 (15-73) and 8.7±10.8 (0-67), respectively. The proportion of cases with positive No.10 LNs was 8.8% (18/205). In all 204 dissected No.10 LNs, 47 LNs (23.0%) were metastatic. In 52.2% (107/205) patients, the dissected splenic hilar tissues were histologically determined as only fat tissues but without LNs structure. Histological evidence of LNs structure was found in 98 (47.8%) patients with 18.4% (18/98) metastatic No.10 LNs. In multivariate logistic regression analysis, metastasis of No.10 LNs was significantly correlated with No.4sa LNs (p = 0.010) and pN stage (p = 0.012). Regarding survival analysis, 199 (97.1%) patients were followed up (0.6-74.8 months). In all patients with R0 resection, metastatic No.10 LNs caused significantly worse prognosis both in Kaplan-Meier (p = 0.006) and Cox regression analysis (p = 0.031). CONCLUSIONS: Although the metastatic rate of No.10 LNs was 8.8%, dissection of No.10 LNs might be meaningful due to the poor prognosis of positive cases. And attentions should be also paid to its correlated factors including pN stage and No.4sa LNs.
- Subjects :
- Male
Pathology
Cancer Treatment
lcsh:Medicine
Kaplan-Meier Estimate
Gastroenterology
Metastasis
Postoperative Complications
Risk Factors
Gastrointestinal Cancers
Medicine and Health Sciences
Stage (cooking)
lcsh:Science
Multidisciplinary
integumentary system
hemic and immune systems
Middle Aged
respiratory system
Prognosis
Dissection
Surgical Oncology
Oncology
Lymphatic Metastasis
Adenocarcinoma
Female
Lymph
tissues
Research Article
medicine.medical_specialty
education
Surgical and Invasive Medical Procedures
Gastroenterology and Hepatology
Digestive System Procedures
Stomach Neoplasms
Internal medicine
Gastrointestinal Tumors
medicine
Humans
Survival analysis
Aged
Neoplasm Staging
business.industry
Proportional hazards model
lcsh:R
Cancers and Neoplasms
Retrospective cohort study
medicine.disease
lcsh:Q
Lymph Nodes
business
Spleen
Subjects
Details
- ISSN :
- 19326203
- Volume :
- 9
- Database :
- OpenAIRE
- Journal :
- PLoS ONE
- Accession number :
- edsair.doi.dedup.....c1ced46b8d81e3fbd431da53ca12ed74