Clinicopathological Factors and Nomogram Construction for Lymph Node Metastasis in Locally Advanced Gastric Cancer.

clinicopathological factors locally advanced gastric cancer lymph node metastasis nomogram

Journal

Cancer management and research
ISSN: 1179-1322
Titre abrégé: Cancer Manag Res
Pays: New Zealand
ID NLM: 101512700

Informations de publication

Date de publication:
2024
Historique:
received: 17 08 2024
accepted: 15 10 2024
medline: 23 10 2024
pubmed: 23 10 2024
entrez: 23 10 2024
Statut: epublish

Résumé

The research on lymph node metastasis (LNM) in locally advanced gastric cancer (LAGC) infiltrating the subserous tissue and serous membrane (T3-4a) is significantly inadequate. This study aims to explore the clinicopathological factors related to LNM in stages T3 and T4a LAGC, while also developing predictive nomograms. After systematic searching and rigorous screening, 1995 T3 and 1244 T4a LAGC cases who underwent surgery without neoadjuvant or perioperative chemotherapy were selected. The risk factors associated with LNM were identified using both univariate and multivariate logistic regression analyses. Subsequently, the independent variables identified through the multivariate analyses were utilized to construct a nomogram. The incidence of LNM in T3 and T4a LAGC was 77.1% (1539/1995) and 83.8% (1043/1244), respectively. The following factors were found to be independently associated with LNM in T3 LAGC: preoperative serum albumin <41g/L (P=0.007), gastrointestinal obstruction (P<0.001), tumor location (P=0.040), tumor size >4cm (P=0.002), mixed (P=0.001) and undifferentiated histological types (P=0.002), presence of lymphovascular invasion (LVI) (P<0.001) and nerve invasion (P<0.001). Additionally, in T4a LAGC cases, serum albumin < 39g/L (P=0.004), tumor size >6cm (P=0.020), mixed (P<0.001) and undifferentiated histological types (P<0.001), presence of gastrointestinal hemorrhage (P=0.016), neuroendocrine differentiation (P=0.024), and LVI (P<0.001) independently influenced the occurrence of LNM. This study identified the risk factors associated with LNM in T3-4a LAGC cases and constructed nomograms, thereby providing valuable guidance for formulating and implementing a multidisciplinary perioperative treatment program.

Sections du résumé

Background UNASSIGNED
The research on lymph node metastasis (LNM) in locally advanced gastric cancer (LAGC) infiltrating the subserous tissue and serous membrane (T3-4a) is significantly inadequate. This study aims to explore the clinicopathological factors related to LNM in stages T3 and T4a LAGC, while also developing predictive nomograms.
Methods UNASSIGNED
After systematic searching and rigorous screening, 1995 T3 and 1244 T4a LAGC cases who underwent surgery without neoadjuvant or perioperative chemotherapy were selected. The risk factors associated with LNM were identified using both univariate and multivariate logistic regression analyses. Subsequently, the independent variables identified through the multivariate analyses were utilized to construct a nomogram.
Results UNASSIGNED
The incidence of LNM in T3 and T4a LAGC was 77.1% (1539/1995) and 83.8% (1043/1244), respectively. The following factors were found to be independently associated with LNM in T3 LAGC: preoperative serum albumin <41g/L (P=0.007), gastrointestinal obstruction (P<0.001), tumor location (P=0.040), tumor size >4cm (P=0.002), mixed (P=0.001) and undifferentiated histological types (P=0.002), presence of lymphovascular invasion (LVI) (P<0.001) and nerve invasion (P<0.001). Additionally, in T4a LAGC cases, serum albumin < 39g/L (P=0.004), tumor size >6cm (P=0.020), mixed (P<0.001) and undifferentiated histological types (P<0.001), presence of gastrointestinal hemorrhage (P=0.016), neuroendocrine differentiation (P=0.024), and LVI (P<0.001) independently influenced the occurrence of LNM.
Conclusion UNASSIGNED
This study identified the risk factors associated with LNM in T3-4a LAGC cases and constructed nomograms, thereby providing valuable guidance for formulating and implementing a multidisciplinary perioperative treatment program.

Identifiants

pubmed: 39439918
doi: 10.2147/CMAR.S487247
pii: 487247
pmc: PMC11495200
doi:

Types de publication

Journal Article

Langues

eng

Pagination

1475-1489

Informations de copyright

© 2024 Yu et al.

Déclaration de conflit d'intérêts

The authors declare that they have no competing interests.

Auteurs

Zhiyuan Yu (Z)

Medical School of Chinese PLA, Beijing, People's Republic of China.
Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China.
School of Medicine, Nankai University, Tianjin, People's Republic of China.

Haopeng Liu (H)

Department of Hepatobiliary Surgery, Zhangqiu District People's Hospital, Jinan, Shandong Province, People's Republic of China.

Rui Li (R)

Medical School of Chinese PLA, Beijing, People's Republic of China.
Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China.
School of Medicine, Nankai University, Tianjin, People's Republic of China.

Liai Hu (L)

School of Medicine, Nankai University, Tianjin, People's Republic of China.

Chun Xiao (C)

Department of General Surgery, PLA Rocket Force Characteristic Medical Center, Beijing, People's Republic of China.

Yunhe Gao (Y)

Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China.

Peiyu Li (P)

Medical School of Chinese PLA, Beijing, People's Republic of China.
Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China.
School of Medicine, Nankai University, Tianjin, People's Republic of China.

Wenquan Liang (W)

Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China.

Sixin Zhou (S)

Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China.

Xudong Zhao (X)

Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China.

Classifications MeSH