Frontiers in oncology · 2026
Regional lymph node metastasis as a risk factor for recurrence in Borrmann type II gastric cancer: particular significance of the no. 7 lymph node.
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Wei Hongfa, Chen Weidong, Zhang Feiran, Zheng Yifeng, Zhang Changhua
Аннотация
BACKGROUND: The Borrmann classification is a well-established system for categorizing gastric cancer (GC). Although Borrmann type II GC is generally associated with favorable outcomes, a subset of patients still experiences recurrence with a poor prognosis. This study identified clinicopathological factors in Borrmann type II GC patients who are surgically targetable, with the aim of guiding gastrointestinal surgeons and improving patient prognosis.
METHODS: A total of 1,824 patients with GC who underwent radical gastrectomy at the First Affiliated Hospital of Sun Yat-sen University (2007-2019) were retrospectively analyzed, with an additional 197 patients from the First Affiliated Hospital of Shantou University Medical College (2014-2017) used for validation.
RESULTS: In the entire cohort, 440 patients (24.1%) were identified as having type II GC. Compared with other types of GC, type II GC is associated with more favorable overall survival. This subtype is characterized by a smaller tumor size and a lower incidence of serosal invasion and lymph node metastasis. Compared with nonrecurrent cases, recurrent cases more commonly involved tumors located in the upper stomach, demonstrated increased lymphatic spread, and were associated with more advanced pTNM staging. Notably, among the second-tier lymph node stations, tumor involvement of the No. 7 lymph nodes emerged as an important risk factor for recurrence. The peritoneum was the most frequent site of recurrence.
CONCLUSIONS: Although type II GC patients usually have a favorable prognosis, disease recurrence dramatically impairs survival. Notably, the involvement of lymph node station No. 7 was an independent predictor of recurrence, indicating the need for meticulous lymphadenectomy and intensive postoperative surveillance.
METHODS: A total of 1,824 patients with GC who underwent radical gastrectomy at the First Affiliated Hospital of Sun Yat-sen University (2007-2019) were retrospectively analyzed, with an additional 197 patients from the First Affiliated Hospital of Shantou University Medical College (2014-2017) used for validation.
RESULTS: In the entire cohort, 440 patients (24.1%) were identified as having type II GC. Compared with other types of GC, type II GC is associated with more favorable overall survival. This subtype is characterized by a smaller tumor size and a lower incidence of serosal invasion and lymph node metastasis. Compared with nonrecurrent cases, recurrent cases more commonly involved tumors located in the upper stomach, demonstrated increased lymphatic spread, and were associated with more advanced pTNM staging. Notably, among the second-tier lymph node stations, tumor involvement of the No. 7 lymph nodes emerged as an important risk factor for recurrence. The peritoneum was the most frequent site of recurrence.
CONCLUSIONS: Although type II GC patients usually have a favorable prognosis, disease recurrence dramatically impairs survival. Notably, the involvement of lymph node station No. 7 was an independent predictor of recurrence, indicating the need for meticulous lymphadenectomy and intensive postoperative surveillance.