Prognostic impact of lymphovascular invasion in node-negative gastric cancer: a retrospective cohort study.

IF 2.5 3区 医学 Q3 ONCOLOGY World Journal of Surgical Oncology Pub Date : 2024-12-20 DOI:10.1186/s12957-024-03629-6
Abdullah Ibrahim Alangari, Sojung Kim, Han Hong Lee, Kyo Young Song, Hoseok Seo
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Abstract

Background: Lymphovascular invasion (LVI) has been identified as a prognostic factor in various cancers, but its significance in node-negative gastric cancer remains unclear. Gastric cancer prognosis is notably affected by lymph node metastasis, with LVI potentially indicating metastatic spread.

Methods: A retrospective review was conducted on 5,699 patients who underwent curative radical gastrectomy for gastric cancer between 1989 and 2018. The median follow-up duration was 62 months (0-362 months). Overall, disease-specific, and disease-free survival were compared based on LVI status and stratified by T stage. Additionally, patients with stage IIA or T2N0 were further evaluated to clarify the clinical significance of LVI in the T2N0 group.

Results: The T2N0 LVI-positive group exhibited significantly poor prognosis than those in the T2N0 LVI-negative group, with no significant differences observed on comparing the T2N0 LVI-positive group with the T2N1 LVI-negative or LVI-positive groups. Furthermore, although the T2N0 LVI-negative group demonstrated better prognosis compared to the IIA group, the T2N0 LVI-positive group exhibited worse survival. In addition, LVI positivity was an independent risk factor for overall survival in T2N0 patients.

Conclusions: LVI in node-negative gastric cancer has clinical significance as a prognostic indicator, indicating an increased risk of disease recurrence and poor survival especially in T2 cohort. This indicates an increased likelihood of lymph node involvement and may influence treatment decisions and follow-up strategies.

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淋巴结阴性胃癌淋巴血管浸润对预后的影响:一项回顾性队列研究。
背景:淋巴血管侵袭(LVI)已被确定为多种癌症的预后因素,但其在淋巴结阴性胃癌中的意义尚不清楚。胃癌预后明显受淋巴结转移的影响,LVI可能提示转移扩散。方法:对1989年至2018年5699例根治性胃癌患者进行回顾性分析。中位随访时间为62个月(0 ~ 362个月)。根据LVI状态并按T期分层,比较总体、疾病特异性和无病生存期。此外,进一步评估IIA期或T2N0期患者,以明确T2N0期患者LVI的临床意义。结果:T2N0 lvi阳性组预后明显差于T2N0 lvi阴性组,T2N0 lvi阳性组与T2N1 lvi阴性、lvi阳性组比较无显著差异。此外,尽管T2N0 lvi阴性组预后较IIA组好,但T2N0 lvi阳性组生存率较IIA组差。此外,LVI阳性是T2N0患者总生存的独立危险因素。结论:淋巴结阴性胃癌的LVI作为预后指标具有临床意义,尤其在T2队列中提示疾病复发风险增高,生存期较差。这表明淋巴结受累的可能性增加,并可能影响治疗决策和随访策略。
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来源期刊
CiteScore
4.70
自引率
15.60%
发文量
362
审稿时长
3 months
期刊介绍: World Journal of Surgical Oncology publishes articles related to surgical oncology and its allied subjects, such as epidemiology, cancer research, biomarkers, prevention, pathology, radiology, cancer treatment, clinical trials, multimodality treatment and molecular biology. Emphasis is placed on original research articles. The journal also publishes significant clinical case reports, as well as balanced and timely reviews on selected topics. Oncology is a multidisciplinary super-speciality of which surgical oncology forms an integral component, especially with solid tumors. Surgical oncologists around the world are involved in research extending from detecting the mechanisms underlying the causation of cancer, to its treatment and prevention. The role of a surgical oncologist extends across the whole continuum of care. With continued developments in diagnosis and treatment, the role of a surgical oncologist is ever-changing. Hence, World Journal of Surgical Oncology aims to keep readers abreast with latest developments that will ultimately influence the work of surgical oncologists.
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