{"title":"胃癌肿大淋巴结转移与生存：多机构术后分析。","authors":"Jing-Li Cui, Kai Zhao, Xiang-Li Li, Fei Wang, Yong-Sheng Yang, Xiao Zheng","doi":"10.5306/wjco.v16.i6.106228","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer (GC) is frequently diagnosed at advanced stages, often with lymph node metastasis (LNM), which complicates prognosis. Swollen LNM (SLNM) in GC has been linked to poor outcomes, yet its prognostic value requires validation.</p><p><strong>Aim: </strong>To evaluate the prognostic significance of SLNM in GC patients undergoing curative-intent gastrectomy.</p><p><strong>Methods: </strong>A retrospective analysis included 507 GC patients with LNM, categorized by SLNM status into positive (SLNM present) and negative (SLNM absent) groups. Survival outcomes were compared between groups, including propensity score matching and multivariate analysis to assess the role of SLNM as an independent prognostic factor.</p><p><strong>Results: </strong>One hundred and thirty-nine (27.4%) patients exhibited SLNM, associated with significantly lower 5-year overall survival (OS) compared to non-SLNM patients (13.6% <i>vs</i> 35.8%, <i>P</i> < 0.001). After matching, SLNM-positive patients maintained worse OS rates (13.4% <i>vs</i> 21.2%, <i>P</i> = 0.006). Multivariate analysis confirmed SLNM as an independent prognostic factor (hazard ratio = 1.318, <i>P</i> = 0.031). Additionally, T4 stage, N3 stage, and neoadjuvant chemotherapy independently influenced survival outcomes for SLNM-positive patients. Those who received neoadjuvant chemotherapy demonstrated better prognosis.</p><p><strong>Conclusion: </strong>SLNM is an independent predictor of poor prognosis in GC. Neoadjuvant chemotherapy followed by D2 gastrectomy and adjuvant chemotherapy may offer survival benefits for patients with SLNM.</p>","PeriodicalId":23802,"journal":{"name":"World journal of clinical oncology","volume":"16 6","pages":"106228"},"PeriodicalIF":3.2000,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198874/pdf/","citationCount":"0","resultStr":"{\"title\":\"Swollen lymph node metastasis and survival in gastric cancer: Multi-institutional post-resection analysis.\",\"authors\":\"Jing-Li Cui, Kai Zhao, Xiang-Li Li, Fei Wang, Yong-Sheng Yang, Xiao Zheng\",\"doi\":\"10.5306/wjco.v16.i6.106228\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Gastric cancer (GC) is frequently diagnosed at advanced stages, often with lymph node metastasis (LNM), which complicates prognosis. Swollen LNM (SLNM) in GC has been linked to poor outcomes, yet its prognostic value requires validation.</p><p><strong>Aim: </strong>To evaluate the prognostic significance of SLNM in GC patients undergoing curative-intent gastrectomy.</p><p><strong>Methods: </strong>A retrospective analysis included 507 GC patients with LNM, categorized by SLNM status into positive (SLNM present) and negative (SLNM absent) groups. Survival outcomes were compared between groups, including propensity score matching and multivariate analysis to assess the role of SLNM as an independent prognostic factor.</p><p><strong>Results: </strong>One hundred and thirty-nine (27.4%) patients exhibited SLNM, associated with significantly lower 5-year overall survival (OS) compared to non-SLNM patients (13.6% <i>vs</i> 35.8%, <i>P</i> < 0.001). After matching, SLNM-positive patients maintained worse OS rates (13.4% <i>vs</i> 21.2%, <i>P</i> = 0.006). Multivariate analysis confirmed SLNM as an independent prognostic factor (hazard ratio = 1.318, <i>P</i> = 0.031). Additionally, T4 stage, N3 stage, and neoadjuvant chemotherapy independently influenced survival outcomes for SLNM-positive patients. Those who received neoadjuvant chemotherapy demonstrated better prognosis.</p><p><strong>Conclusion: </strong>SLNM is an independent predictor of poor prognosis in GC. 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引用次数: 0
摘要
背景：胃癌（GC）常在晚期诊断，常伴有淋巴结转移（LNM），使预后复杂化。胃癌中肿大的LNM （SLNM）与预后不良有关，但其预后价值有待验证。目的：探讨SLNM在胃癌患者行根治性胃切除术中的预后意义。方法：回顾性分析507例胃癌伴LNM患者，按SLNM状态分为阳性组（有SLNM）和阴性组（无SLNM）。比较各组之间的生存结果，包括倾向评分匹配和多变量分析，以评估SLNM作为独立预后因素的作用。结果：139例（27.4%）患者出现SLNM，与非SLNM患者相比，其5年总生存率（OS）显著降低（13.6% vs 35.8%, P < 0.001）。配对后，slnm阳性患者的OS率较差（13.4% vs 21.2%, P = 0.006）。多因素分析证实SLNM为独立预后因素（风险比= 1.318,P = 0.031）。此外，T4期、N3期和新辅助化疗单独影响slnm阳性患者的生存结果。接受新辅助化疗的患者预后较好。结论：SLNM是胃癌预后不良的独立预测因子。新辅助化疗后D2胃切除术和辅助化疗可能为SLNM患者提供生存益处。
Swollen lymph node metastasis and survival in gastric cancer: Multi-institutional post-resection analysis.
Background: Gastric cancer (GC) is frequently diagnosed at advanced stages, often with lymph node metastasis (LNM), which complicates prognosis. Swollen LNM (SLNM) in GC has been linked to poor outcomes, yet its prognostic value requires validation.
Aim: To evaluate the prognostic significance of SLNM in GC patients undergoing curative-intent gastrectomy.
Methods: A retrospective analysis included 507 GC patients with LNM, categorized by SLNM status into positive (SLNM present) and negative (SLNM absent) groups. Survival outcomes were compared between groups, including propensity score matching and multivariate analysis to assess the role of SLNM as an independent prognostic factor.
Results: One hundred and thirty-nine (27.4%) patients exhibited SLNM, associated with significantly lower 5-year overall survival (OS) compared to non-SLNM patients (13.6% vs 35.8%, P < 0.001). After matching, SLNM-positive patients maintained worse OS rates (13.4% vs 21.2%, P = 0.006). Multivariate analysis confirmed SLNM as an independent prognostic factor (hazard ratio = 1.318, P = 0.031). Additionally, T4 stage, N3 stage, and neoadjuvant chemotherapy independently influenced survival outcomes for SLNM-positive patients. Those who received neoadjuvant chemotherapy demonstrated better prognosis.
Conclusion: SLNM is an independent predictor of poor prognosis in GC. Neoadjuvant chemotherapy followed by D2 gastrectomy and adjuvant chemotherapy may offer survival benefits for patients with SLNM.
期刊介绍：
The WJCO is a high-quality, peer reviewed, open-access journal. The primary task of WJCO is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of oncology. In order to promote productive academic communication, the peer review process for the WJCO is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJCO are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in oncology. Scope: Art of Oncology, Biology of Neoplasia, Breast Cancer, Cancer Prevention and Control, Cancer-Related Complications, Diagnosis in Oncology, Gastrointestinal Cancer, Genetic Testing For Cancer, Gynecologic Cancer, Head and Neck Cancer, Hematologic Malignancy, Lung Cancer, Melanoma, Molecular Oncology, Neurooncology, Palliative and Supportive Care, Pediatric Oncology, Surgical Oncology, Translational Oncology, and Urologic Oncology.
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