Korean Journal of Clinical Oncology (대한종양외과학회지)

Korean Society of Surgical Oncology (대한종양외과학회)
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The impact of lymph node count on survival in gastric cancer

  • Ahn, Ha Rim (Division of Gastrointestinal Surgery, Department of Surgery, Chonbuk National University College of Medicine) ;
  • Han, Se Wung (Division of Gastrointestinal Surgery, Department of Surgery, Chonbuk National University College of Medicine) ;
  • Yang, Doo Hyun (Division of Gastrointestinal Surgery, Department of Surgery, Chonbuk National University College of Medicine) ;
  • Kim, Chan Young (Division of Gastrointestinal Surgery, Department of Surgery, Chonbuk National University College of Medicine)
  • Received : 2018.08.24
  • Accepted : 2018.11.12
  • Published : 2018.12.31
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Abstract

Purpose: The purpose of this study was to determine the immunologic role of lymph node (LN) and stage migration by assessing LN count and metastatic LN count. Methods: A total of 2,117 patients with gastric adenocarcinoma located in the body and antrum who underwent distal/subtotal gastrectomy with D2 LN dissection between January 1, 1998 and December 31, 2008 were enrolled. LN count and number of metastases were determined in the N1 tier (area of D1 dissection) and N2 tier (area of D2 dissection). The lower and upper quartiles of LN counts in the same pN stage were grouped to compare the prognosis and LN positivity according to the LN tier. Results: Stage migration from N1 tier to N2 tier occurred in 3.2% of cases. The 5-year disease-specific survival rates of the upper and lower LN count groups within the N1 tier were 91.0% and 86.7% (P=0.01), respectively. LN positivity in the N2 tier of the lower LN count group was higher than that of the upper LN count group (14.1% vs. 8.2%, P<0.01). Stage migration in the N2 tier of the lower LN count group was also higher than that of the upper LN count group (4.6% vs. 1.8%, P<0.01). Conclusion: The lower LN count group had a decreased survival rate compared to that of the upper LN count group, suggesting that perigastric LN has an immunological defense role in weakening the disseminating power of metastatic tumor cells, as indicated by the LN count.

Keywords

References

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