Clinicopathological Factors Predisposing to No. 12a Lymph Node Metastasis in Gastric Cancer: A Prospective Cohort Analysis

IF 1.5 Q4 ONCOLOGY

Cancer reports Pub Date : 2025-06-11 DOI:10.1002/cnr2.70239

Amirmohsen Jalaeefar, Habibollah Mahmoodzadeh, Mohammad Shirkhoda, Ramesh Omranipour, Seyed Rouhollah Miri, Narjes Mohammadzadeh, Arshia Zardoui, Amirsina Sharifi

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Abstract

Background

The current standard surgical procedure for gastric cancer (GC) is gastrectomy and D2 lymphadenectomy, which includes harvesting No. 12a lymph node (LN) station.

Aim

The purpose of this study was to identify the clinicopathologic factors associated with No. 12a lymph node metastasis.

Methods and Results

Eighty-nine patients with GC undergoing gastrectomy and D2 lymphadenectomy were included in this single-arm prospective cohort study. Logistic regression analyses were used to clarify the correlation between No. 12a involvement and clinicopathologic characteristics. Eighty-nine patients (66% males) with a mean age of 58.86 ± 13.06 years were included. The upper third of the stomach was the most common tumor site (43.8%). neoadjuvant chemotherapy (NAC) was administered to 77 patients (86.5%). Total gastrectomy was the most common surgical procedure (67.4%), and 49.4% of tumors were poorly differentiated. Ten patients (11.24%) had 12a LN metastasis. Patients with 12a LN involvement exhibited greater number of harvested LNs in other stations (28.5[27–39.25] vs. 25[21–30], p = 0.024) and a higher presence of LN involvement in other stations (22[11–32] vs. 0[0–4], p = < 0.001). Univariate logistic regression analysis showed that the number of harvested other nodes (OR: 1.11[1.02–1.21]), number of involved other nodes (1.23[1.11–1.37]), omental involvement (OR: 10.86[1.84–64.24.57]), lymphovascular invasion (6.90[1.37–34.70]), and perineuronal invasion (OR: 6.16[1.23–31.11]) were significantly associated with No. 12a station metastasis. However, in multivariate logistic regression, only the number of involved other nodes showed a significant association with No. 12a station metastasis (OR: 1.30[1.09–1.55]). There was no difference between patients who received NAC and who did not in terms of No. 12a involvement (p value = 0.61).

Conclusion

Among clinicopathologic risk factors, involvement of other lymph node stations was significantly associated with No. 12a lymph node metastasis. Therefore, No. 12a lymph node dissection should be considered in patients with advanced gastric cancer.

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胃癌12a淋巴结转移的临床病理因素：一项前瞻性队列分析

目前胃癌（GC）的标准手术是胃切除术和D2淋巴结切除术，其中包括12a淋巴结（LN）站的切除。目的探讨与No. 12a淋巴结转移相关的临床病理因素。方法和结果89例胃癌患者行胃切除术和D2淋巴结切除术，纳入单臂前瞻性队列研究。采用Logistic回归分析明确No. 12a受累与临床病理特征的相关性。89例患者（男性66%），平均年龄58.86±13.06岁。胃上三分之一是最常见的肿瘤部位（43.8%）。新辅助化疗77例（86.5%）。全胃切除术是最常见的手术方式（67.4%），49.4%的肿瘤是低分化的。10例（11.24%）有12a淋巴结转移。12a淋巴结受累的患者在其他部位有更多的淋巴结被切除（28.5[27-39.25]对25[21-30]，p = 0.024），其他部位有更多的淋巴结受累（22[11-32]对0[0 - 4]，p = < 0.001）。单因素logistic回归分析显示，其他淋巴结清扫数（OR: 1.11[1.02-1.21]）、其他淋巴结受累数（OR: 1.23[1.11 - 1.37]）、网膜受累数（OR: 10.86[1.84-64.24.57]）、淋巴血管浸润（OR: 6.90[1.37-34.70]）、神经元周围浸润（OR: 6.16[1.23 - 31.11]）与No. 12a站转移显著相关。然而，在多变量logistic回归中，只有受援的其他淋巴结数量与No. 12a站转移有显著相关性（OR: 1.30[1.09-1.55]）。接受NAC的患者与未接受NAC的患者在no . 12a受损伤方面没有差异（p值= 0.61）。结论在临床病理危险因素中，浸润其他淋巴结与No. 12a淋巴结转移显著相关。因此，晚期胃癌患者应考虑No. 12a淋巴结清扫术。

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