Risk Factors And Prognostic Impact Of No.10 Lymph Nodes Metastasis For Patients With Advanced Gastric Cancer In The Upper And/or The Middle Third Of The Stomach And Receiving Spleen-preserving Radical Resection

Objective:To explore the risk factors and prognostic impact of No.10 LNs(splenic hilar lymph nodes) metastasis in cases with the patients with advanced gastric cancer in the upper and/or the middle third of the stomach and receiving spleen-preserving radical resection.Method:The data of 243 patients with advanced gastric cancer in the upper and/or the middle third of the stomach and receiving spleen-preserving radical resection were screened from the database of our hospital from June 1st 2008 to August 31st2012.According to No.10 LNs metastasis. They were divided into positive(n=21) and negative(n=222) groups. Their clinicopathological parameters and survival outcomes were compared. The risk factors and prognostic impact of No.10 LNs metastasis were analyzed.Results:The metastatic rates of No.10 LNs were 8.6%(21/243) in all patients.It was no significance compared in two groups with genders,ages,tumor lengthwise position,preoperative serum CEA levels,Lauren types and perineural invasio. Metastasis of No.10 LNs was correlated with preoperative serum CA72-4 levels, tumor size,cross sectional location,Borrmann types,depth of tumor invasion(pT stage),the number of metastatic lymph nodes(pN stage),TNM stage,differentiation grade, vascular invasion and the cancerous nodules formed around stomach in univariate correlation analysis(P<0.05,respectively). Logistic regression analysis showed TNM stage(pT4), vascular invasion and the cancerous nodules formed around stomach was closely correlation with No.10 LNs metastasis(P<0.05,respectively). In positive and negative groups, 3-years overall survival(OS) was 12.6% VS 61.3%(x~2 =21.934,P<0.001); 2-years disease-free survival(DFS) was 15.9% VS 70.0%(x~2 =34.868,P<0.001); the positive group had poorlysurvival. Cox regression analysis showed depth of tumor invasion(pT4),TNM stage(â…¢C),the cancerous nodules formed around stomach and metastasis of No.10 LNs(HR=2.777,P=0.041,CI:1.042~7.404) were closely correlated with survival of advanced up-mid third gastric cancer patients receiving spleen-preserving radical resection.Conclusion:For patients with advanced gastric cancer in the upper and/or the middle third of the stomach and receiving spleen-preserving radical resection, TNM stage(â…¢C),vascular invasion and the cancerous nodules formed around stomach were independent risk factors of No.10 LNs metastasis. Depth of tumor invasion(pT4),TNM stage(â…¢C),vascular invasion, the cancerous nodules forming around stomach and metastasis of No.10 LNs were independent prognostic factors about poor 3-years overall survival.