Surgical oncology · 2026
Nodal metastatic pattern in gastric cancer: A descriptive study of a single institution cohort.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Schelletter Marlene, Chevallay Mickael, Rubbia-Brandt Laura, Toso Christian, Mönig Stefan Paul, Jung Minoa Karin
Аннотация
INTRODUCTION: Gastric cancer exhibits diverse patterns of lymph node (LN) metastasis, yet the relationship between LN stations and tumor location, histological subtype and pT-stage remains unclear. This study aims to describe nodal metastatic drainage patterns in gastric adenocarcinoma and potential predictive factors.
MATERIALS AND METHODS: Between May 2016 and December 2022, 86 patients undergoing total or subtotal gastrectomy for gastric cancer were included. Retrieved LN stations were analyzed.
RESULTS: Positive LN metastasis was observed in 42 patients (49%). The median number of harvested LNs was 44 (IQR, 34.75-58.50), with a mortality rate of 0%. Middle tumors had the highest prevalence of LN metastasis (53%), followed by proximal (48%) and distal tumors (45%). Proximal tumors primarily metastasized to LN stations 2, 6 (16%; 16%) and 9 (12%), while middle third tumors at LN stations 3 and 7 (21%; 21%). Distal tumors showed the highest frequency of metastasis in distal LN stations 4d (8%) and 6 (15%). Diffuse (50%) and mixed type (72%) gastric cancers exhibited higher LN metastases compared to intestinal-type tumors (42%). Larger tumor size (p = 0.002), advanced pT-stage (p < 0.001), and lymphatic or vascular invasion (p < 0.001) significantly correlated with increased metastases. Multivariate analysis revealed a significant correlation between positive LN metastasis and advanced pT-stage (p = 0.011).
CONCLUSIONS: Patterns of LN metastasis are influenced by tumor location, but can also occur at any LN station, irrespective of tumor location, pT-stage, or histological subtype. Higher pT-stage significantly increases the likelihood for LN metastases.
MATERIALS AND METHODS: Between May 2016 and December 2022, 86 patients undergoing total or subtotal gastrectomy for gastric cancer were included. Retrieved LN stations were analyzed.
RESULTS: Positive LN metastasis was observed in 42 patients (49%). The median number of harvested LNs was 44 (IQR, 34.75-58.50), with a mortality rate of 0%. Middle tumors had the highest prevalence of LN metastasis (53%), followed by proximal (48%) and distal tumors (45%). Proximal tumors primarily metastasized to LN stations 2, 6 (16%; 16%) and 9 (12%), while middle third tumors at LN stations 3 and 7 (21%; 21%). Distal tumors showed the highest frequency of metastasis in distal LN stations 4d (8%) and 6 (15%). Diffuse (50%) and mixed type (72%) gastric cancers exhibited higher LN metastases compared to intestinal-type tumors (42%). Larger tumor size (p = 0.002), advanced pT-stage (p < 0.001), and lymphatic or vascular invasion (p < 0.001) significantly correlated with increased metastases. Multivariate analysis revealed a significant correlation between positive LN metastasis and advanced pT-stage (p = 0.011).
CONCLUSIONS: Patterns of LN metastasis are influenced by tumor location, but can also occur at any LN station, irrespective of tumor location, pT-stage, or histological subtype. Higher pT-stage significantly increases the likelihood for LN metastases.