WANG Jinshu 1,2,3 , WANG Ruikang 1 , ZHANG Xinzhong 1,2,3 , WANG Wei 3 , LIU Gang 1,2,3
  • 1. Xinxiang Medical University, Xinxiang, Henan 453003, P. R. China;
  • 2. Department of Oncology, People’s Hospitai of Henan, Zhengzhou 450003, P. R. China;
  • 3. Clinical Single Cell Biomedicine Center, People’s Hospitai of Henan, Zhengzhou 450003, P. R. China;
LIU Gang, Email: zzdxliugang@126.com
advanced gastric cancer; laparoscope; radical gastrectomy; number of harvested lymph node
10.7507/1007-9424.202011021
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Objective To analyze the factors influencing the total number of harvested lymph nodes in laparoscopic radical gastrectomy for advanced gastric cancer.Methods The clinicopathologic data of patients who underwent laparoscopic D2 radical resection of gastric cancer in this hospital for advanced gastric cancer from January 2018 to July 2020 were retrospectively analyzed. The statistical analysis was conducted to analyze the influence factors (age, gender, tumor size, tumor site, body mass index, infiltration depth, lymph node metastasis, HER-2 gene amplification status, presence or absence of vascular tumor thrombus, presence or absence of nerve infiltration, differentiation type, pTNM, Borrmann type, and type of gastrectomy) on the number of harvested lymph nodes.Results A total of 536 patients met the inclusion and exclusion criteria were included. The results of univariate analysis showed that the total number of harvested lymph nodes during laparoscopic radical gastrectomy for advanced gastric cancer was correlated with age, tumor size, tumor infiltration depth, lymph node metastasis, pTNM stage, Borrmann type, and type of gastrectomy. That was, the younger the patient was (≤ 54 years old), the larger the tumor was (long diameter >3.5 cm), the later the Borrmann classification was (type Ⅲ, Ⅳ), the deeper the tumor invasion was, the more the number of lymph node metastasis was, the later the pTNM stage was, and the more the number of lymph nodes was detected in patients undergoing total gastrectomy (all P<0.05). The multiple linear regression analysis showed that the age, lymph node metastasis, and PTNM stage had significant effects on the number of harvested lymph nodes. The multiple linear regression model was statistically significant (F=6.754, P<0.001). 11.2% of the variation in the number of harvested lymph nodes could be explained by the age, lymph node metastasis, and pTNM stage (adjusted R2=11.2%). Conclusions Number of harvested lymph nodes in laparoscopic radical gastrectomy for advanced gastric cancer is greatly affected by the age of patients, lymph node metastasis, and pTNM stage. So patients should be evaluated objectively and individually according to their age so as to harvest sufficient number of lymph nodes, which is conducive to accurately judge pTNM stage, formulate accurate adjuvant treatment scheme, and improve prognosis of patients.

Citation： WANG Jinshu, WANG Ruikang, ZHANG Xinzhong, WANG Wei, LIU Gang. Analysis of factors influencing total number of harvested lymph nodes in laparoscopic radical gastrectomy for advanced gastric cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(6): 732-736. doi: 10.7507/1007-9424.202011021 Copy

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