Risk factors for No. 12p and No. 12b lymph node metastases in advanced gastric cancer in China

Ji- Feng Feng,Ying Huang,Jing Liu,Huang Liu,Hua-Ying Sheng,Wei-Tian Wei,Wei-Shan Lu,Da-Feng Chen,Wen-You Chen,Xing-Ming Zhou

doi:10.3109/03009734.2012.729103

Ji- Feng Feng, Ying Huang + Show 8 more

Open Access

https://doi.org/10.3109/03009734.2012.729103

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Abstract

Background. The risk factors for No. 12p and No. 12b lymph node (LN) metastases in advanced gastric cancer (GC) remain controversial. The aim of this study was to investigate the risk factors for No. 12p and No. 12b LN metastases in advanced GC.Methods. From January 1999 to December 2005, a retrospective analysis of 163 patients with advanced GC who underwent D2 lymphadenectomy in addition to No. 12p and No. 12b LN dissections was conducted. Potential clinicopathological factors that could influence No. 12p and No. 12b LN metastases were statistically analyzed.Results. There were 15 cases (9.2%) with No. 12p LN metastases and 5 cases (3.1%) with synchronous No. 12b LN metastases. A logistic regression analysis revealed that the Borrmann type (III/IV versus I/II, P = 0.029), localization (lesser/circular versus greater, P = 0.025), and depth of invasion (pT4 versus pT2/pT3, P = 0.009) were associated with 11.1-, 3.8-, and 5.6-fold increases, respectively, for risk of No. 12p and No. 12b LN metastases. A logistic regression analysis also showed that No. 5 (P = 0.006) and No. 12a (P = 0.004) LN metastases were associated with 6.9- and 11.3-fold increases, respectively, for risk of No. 12p and No. 12b LN metastases. In addition, significant differences in 5-year survival of patients with and without No. 12p and No. 12b LN metastases were observed (13.3% versus 35.1%, P = 0.022).Conclusion. We conclude that Borrmann type, localization, and depth of invasion are significant variables for identifying patients with No. 12p and No. 12b LN metastases. Individuals with No. 5 or No. 12a LN metastases should be on high alert for the possibility of additional metastases to the No. 12p and No. 12b LNs.

Highlights

The incidence of gastric cancer (GC) has been declining in recent years, it remains one of the most important causes of cancer-related death in China [1,2,3]
From the variables considered to be potentially associated with No 12p and No 12b lymph node (LN) metastases, age (P = 0.017), Borrmann type (P = 0.005), localization (P = 0.024), tumor size (P = 0.007), and depth of invasion (P = 0.000) were found to differ significantly between patients with and without No 12p and No 12b LN metastases (Table III)
A logistic regression analysis showed that the Borrmann type (III/IV versus I/II, P = 0.029), localization, and depth of invasion were associated with 11.1, 3.8, and 5.6-fold increases, respectively, for risk of No 12p and No 12b LN metastases (Table IV)

Summary

Introduction

The incidence of gastric cancer (GC) has been declining in recent years, it remains one of the most important causes of cancer-related death in China [1,2,3]. Curative surgery is the treatment of choice for GC, and radical lymph node (LN) dissection is an important part of curative resection [4,5]. The risk factors for No 12p and No 12b lymph node (LN) metastases in advanced gastric cancer (GC) remain controversial. A logistic regression analysis revealed that the Borrmann type (III/IV versus I/II, P = 0.029), localization (lesser/circular versus greater, P = 0.025), and depth of invasion (pT4 versus pT2/pT3, P = 0.009) were associated with 11.1-, 3.8-, and 5.6-fold increases, respectively, for risk of No 12p and No 12b LN metastases. Individuals with No 5 or No 12a LN metastases should be on high alert for the possibility of additional metastases to the No 12p and No 12b LNs

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