Anatomic extent of metastatic lymph nodes

Still important for gastric cancer prognosis

Taeil Son, WooJin Hyung, Jong Won Kim, Hyoung Il Kim, Ji Yeong An, Jae Ho Cheong, Seung Ho Choi, Sung Hoon Noh

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: Currently, gastric cancer staging systems do not consider the anatomic extent of metastatic lymph nodes (mLNs) as a prognostic factor. We therefore investigated the prognostic impact of the anatomic extent of mLNs on gastric cancer. Methods: The prognoses of 4,043 gastric cancer patients who underwent curative resection were analyzed. Patients with mLNs in lymph node (LN) stations 1-6 (n = 1,980) comprised the perigastric LN-positive (PLN) group, and patients with mLNs in LN stations 7-12 and 14 (n = 2,063) were assigned to the extraperigastric LN-positive (ELN) group. Overall survival was estimated using the Kaplan-Meier method, and hazard ratios (HRs) were calculated by the Cox proportional hazard model. Results: The ELN group exhibited worse survival than the PLN group (p < 0.001), although there were differences in their clinicopathological features. When patients were stratified according to tumor-node-metastasis stage, the ELN groups had unfavorable prognoses compared with the PLN groups (p < 0.05). There were significant differences in long-term survival when the nodal stage of the current staging systems were subdivided according to anatomic nodal extent (p < 0.05), although there was a strong association between the probability of having extraperigastric mLNs and N classification. In multivariate analysis using age, gender, tumor size, tumor location, histology, T classification, and the extent of mLNs as covariates, presence of extraperigastric mLNs was an independent prognostic factor (HR 1.89, 95 % CI 1.73-2.07), along with age, tumor size, tumor location, and T classification. Conclusions: The anatomic extent of mLNs significantly affects patient prognosis. Including the anatomic extent of mLNs in the current staging system may predict gastric cancer prognosis more accurately in patients with the same stage of cancer.

Original languageEnglish
Pages (from-to)899-907
Number of pages9
JournalAnnals of Surgical Oncology
Volume21
Issue number3
DOIs
Publication statusPublished - 2014 Mar 1

Fingerprint

Stomach Neoplasms
Lymph Nodes
Neoplasms
Survival
Neoplasm Staging
Proportional Hazards Models
Histology
Multivariate Analysis
Neoplasm Metastasis

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

Son, Taeil ; Hyung, WooJin ; Kim, Jong Won ; Kim, Hyoung Il ; An, Ji Yeong ; Cheong, Jae Ho ; Choi, Seung Ho ; Noh, Sung Hoon. / Anatomic extent of metastatic lymph nodes : Still important for gastric cancer prognosis. In: Annals of Surgical Oncology. 2014 ; Vol. 21, No. 3. pp. 899-907.
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title = "Anatomic extent of metastatic lymph nodes: Still important for gastric cancer prognosis",
abstract = "Background: Currently, gastric cancer staging systems do not consider the anatomic extent of metastatic lymph nodes (mLNs) as a prognostic factor. We therefore investigated the prognostic impact of the anatomic extent of mLNs on gastric cancer. Methods: The prognoses of 4,043 gastric cancer patients who underwent curative resection were analyzed. Patients with mLNs in lymph node (LN) stations 1-6 (n = 1,980) comprised the perigastric LN-positive (PLN) group, and patients with mLNs in LN stations 7-12 and 14 (n = 2,063) were assigned to the extraperigastric LN-positive (ELN) group. Overall survival was estimated using the Kaplan-Meier method, and hazard ratios (HRs) were calculated by the Cox proportional hazard model. Results: The ELN group exhibited worse survival than the PLN group (p < 0.001), although there were differences in their clinicopathological features. When patients were stratified according to tumor-node-metastasis stage, the ELN groups had unfavorable prognoses compared with the PLN groups (p < 0.05). There were significant differences in long-term survival when the nodal stage of the current staging systems were subdivided according to anatomic nodal extent (p < 0.05), although there was a strong association between the probability of having extraperigastric mLNs and N classification. In multivariate analysis using age, gender, tumor size, tumor location, histology, T classification, and the extent of mLNs as covariates, presence of extraperigastric mLNs was an independent prognostic factor (HR 1.89, 95 {\%} CI 1.73-2.07), along with age, tumor size, tumor location, and T classification. Conclusions: The anatomic extent of mLNs significantly affects patient prognosis. Including the anatomic extent of mLNs in the current staging system may predict gastric cancer prognosis more accurately in patients with the same stage of cancer.",
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Anatomic extent of metastatic lymph nodes : Still important for gastric cancer prognosis. / Son, Taeil; Hyung, WooJin; Kim, Jong Won; Kim, Hyoung Il; An, Ji Yeong; Cheong, Jae Ho; Choi, Seung Ho; Noh, Sung Hoon.

In: Annals of Surgical Oncology, Vol. 21, No. 3, 01.03.2014, p. 899-907.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Anatomic extent of metastatic lymph nodes

T2 - Still important for gastric cancer prognosis

AU - Son, Taeil

AU - Hyung, WooJin

AU - Kim, Jong Won

AU - Kim, Hyoung Il

AU - An, Ji Yeong

AU - Cheong, Jae Ho

AU - Choi, Seung Ho

AU - Noh, Sung Hoon

PY - 2014/3/1

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N2 - Background: Currently, gastric cancer staging systems do not consider the anatomic extent of metastatic lymph nodes (mLNs) as a prognostic factor. We therefore investigated the prognostic impact of the anatomic extent of mLNs on gastric cancer. Methods: The prognoses of 4,043 gastric cancer patients who underwent curative resection were analyzed. Patients with mLNs in lymph node (LN) stations 1-6 (n = 1,980) comprised the perigastric LN-positive (PLN) group, and patients with mLNs in LN stations 7-12 and 14 (n = 2,063) were assigned to the extraperigastric LN-positive (ELN) group. Overall survival was estimated using the Kaplan-Meier method, and hazard ratios (HRs) were calculated by the Cox proportional hazard model. Results: The ELN group exhibited worse survival than the PLN group (p < 0.001), although there were differences in their clinicopathological features. When patients were stratified according to tumor-node-metastasis stage, the ELN groups had unfavorable prognoses compared with the PLN groups (p < 0.05). There were significant differences in long-term survival when the nodal stage of the current staging systems were subdivided according to anatomic nodal extent (p < 0.05), although there was a strong association between the probability of having extraperigastric mLNs and N classification. In multivariate analysis using age, gender, tumor size, tumor location, histology, T classification, and the extent of mLNs as covariates, presence of extraperigastric mLNs was an independent prognostic factor (HR 1.89, 95 % CI 1.73-2.07), along with age, tumor size, tumor location, and T classification. Conclusions: The anatomic extent of mLNs significantly affects patient prognosis. Including the anatomic extent of mLNs in the current staging system may predict gastric cancer prognosis more accurately in patients with the same stage of cancer.

AB - Background: Currently, gastric cancer staging systems do not consider the anatomic extent of metastatic lymph nodes (mLNs) as a prognostic factor. We therefore investigated the prognostic impact of the anatomic extent of mLNs on gastric cancer. Methods: The prognoses of 4,043 gastric cancer patients who underwent curative resection were analyzed. Patients with mLNs in lymph node (LN) stations 1-6 (n = 1,980) comprised the perigastric LN-positive (PLN) group, and patients with mLNs in LN stations 7-12 and 14 (n = 2,063) were assigned to the extraperigastric LN-positive (ELN) group. Overall survival was estimated using the Kaplan-Meier method, and hazard ratios (HRs) were calculated by the Cox proportional hazard model. Results: The ELN group exhibited worse survival than the PLN group (p < 0.001), although there were differences in their clinicopathological features. When patients were stratified according to tumor-node-metastasis stage, the ELN groups had unfavorable prognoses compared with the PLN groups (p < 0.05). There were significant differences in long-term survival when the nodal stage of the current staging systems were subdivided according to anatomic nodal extent (p < 0.05), although there was a strong association between the probability of having extraperigastric mLNs and N classification. In multivariate analysis using age, gender, tumor size, tumor location, histology, T classification, and the extent of mLNs as covariates, presence of extraperigastric mLNs was an independent prognostic factor (HR 1.89, 95 % CI 1.73-2.07), along with age, tumor size, tumor location, and T classification. Conclusions: The anatomic extent of mLNs significantly affects patient prognosis. Including the anatomic extent of mLNs in the current staging system may predict gastric cancer prognosis more accurately in patients with the same stage of cancer.

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