Chun-Dong Zhang1, Fei-Long Ning2, Xian-Tao Zeng3, Dong-Qiu Dai4. 1. Department of Gastrointestinal Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, China. 2. Department of General Surgery, Xuzhou Hospital of Traditional Chinese Medicine, Xuzhou, Jiangsu, China. 3. Department of Evidence-Based and Clinical Epidemiology, The Second Clinical College, Wuhan University, Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China. 4. Department of Gastrointestinal Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, China; Cancer Research Institute, China Medical University, Shenyang, Liaoning, China; Cancer Center, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, China. Electronic address: cmudaidq@126.com.
Abstract
BACKGROUND: Accumulating evidence has confirmed the potential prognostic value of LVI in patients with cancers. This aim of the current study was to clarify the potential relationship between LVI and lymph node metastasis, establish predictive clinicopathologic prognostic factors for LVI and lymph node metastasis, and determine the prognostic significance of LVI for patients younger than 70 years with resected gastric cancer. METHODS: Overall survival rates were calculated using Kaplan-Meier analysis. Differences in proportions of patients were tested with the χ2 test. Univariate and multivariate analyses were applied to identify independent prognostic factors. Logistic regression analysis was employed to identify the risk factors predicting the presence of LVI and LN metastasis. RESULTS: Univariate analysis led to the identification of tumor size, LVI and pN stage as factors significantly correlated with prognosis. Multivariate analysis demonstrated that tumor size, LVI, pN stage, and number of LNs retrieved are independent prognostic factors for the entire population. Logistic regression analysis proved that LVI and pT stage were significantly associated with LN metastasis. CONCLUSION: LVI is an independent prognostic factor predicting LN metastasis and a strongly independent predictor of survival for patients with resected gastric cancer. We recommend that LVI should be taken into account as an important adjuvant prognostic factor, specially for pN0 cases with inadequate LNs retrieved. And the maximum number of LNs possible should be retrieved for optimal staging, especially for patients with higher cT stage.
BACKGROUND: Accumulating evidence has confirmed the potential prognostic value of LVI in patients with cancers. This aim of the current study was to clarify the potential relationship between LVI and lymph node metastasis, establish predictive clinicopathologic prognostic factors for LVI and lymph node metastasis, and determine the prognostic significance of LVI for patients younger than 70 years with resected gastric cancer. METHODS: Overall survival rates were calculated using Kaplan-Meier analysis. Differences in proportions of patients were tested with the χ2 test. Univariate and multivariate analyses were applied to identify independent prognostic factors. Logistic regression analysis was employed to identify the risk factors predicting the presence of LVI and LN metastasis. RESULTS: Univariate analysis led to the identification of tumor size, LVI and pN stage as factors significantly correlated with prognosis. Multivariate analysis demonstrated that tumor size, LVI, pN stage, and number of LNs retrieved are independent prognostic factors for the entire population. Logistic regression analysis proved that LVI and pT stage were significantly associated with LN metastasis. CONCLUSION: LVI is an independent prognostic factor predicting LN metastasis and a strongly independent predictor of survival for patients with resected gastric cancer. We recommend that LVI should be taken into account as an important adjuvant prognostic factor, specially for pN0 cases with inadequate LNs retrieved. And the maximum number of LNs possible should be retrieved for optimal staging, especially for patients with higher cT stage.
Authors: Alisa N Blumenthaler; Timothy E Newhook; Naruhiko Ikoma; Jeannelyn S Estrella; Mariela Blum Murphy; Prajnan Das; Bruce D Minsky; Jaffer A Ajani; Paul F Mansfield; Brian D Badgwell Journal: J Surg Oncol Date: 2021-01-05 Impact factor: 3.454
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