title: [Analysis of risk factors and prognosis of No.8p lymph node metastasis in cases with advanced gastric cancer].
abstract: OBJECTIVE
  To explore the risk factors and prognosis of No.8p lymph node metastasis in cases with advanced gastric cancer.
  
  
  METHODS
  Clinicopathological and follow-up data of 790 cases with advanced gastric cancer undergoing gastrectomy (including No.8p lymphadenectomy) from October 2003 to October 2013 in Fujian Provincial Tumor Hospital were analyzed retrospectively. Patients receiving neoadjuvant chemotherapy were excluded. Associations of No.8p lymph node metastasis with clinicopathological characteristics and metastasis in other regional lymph node were analyzed. Prognostic difference between positive No.8p group and negative No.8p group was examined.
  
  
  RESULTS
  Positive No.8p lymph node was found in 93 cases (11.8%) among 790 cases with advanced gastric cancer. Univariate analysis showed that gender [male 9.8%(56/572) vs. female 17.0%(37/218), P=0.005], preoperative CEA level [<5 μg/L 28.0%(61/218) vs. ≥5 μg/L 5.6%(32/572), P=0.005], tumor size[diameter <5 cm 3.8%(13/346) vs. ≥5 cm 18.0%(80/445), P=0.000], tumor location [gastric fundus and cardiac 10.7% (26/244) vs. gastric body 13.5% (30/222) vs. gastric antrum 10.1% (31/308) vs. total gastric 37.5%(6/16), P=0.007], Borrmann staging [type II( 1.9%(4/211) vs. type III( 11.6% (54/464) vs. type IIII( 30.4%(35/115), P=0.000], tumor differentiation [high 0/8 vs. moderate 6.7%(25/372) vs. low 16.6%(68/410), P=0.000], T staging [T2 2.4%(4/170) vs. T3 13.1%(35/267) vs. T4 15.3%(54/353), P=0.000], N staging [N0 0 (0/227) vs. N1 2.2%(5/223) vs. N2 15.2%(26/171) vs. N3 36.7%(62/169), P=0.000] were closely associated with the No.8p lymph node metastasis. Multivariate analysis that revealed gender (OR=1.762, 95%CI: 1.020-3.043), tumor size (OR=1.107, 95%CI: 1.020-1.203), N staging (OR=4.093, 95%CI: 2.929-5.718), tumor differentiation (OR=1.782, 95%CI:1.042-3.049), and metastasis in No.8a(OR=5.370, 95%CI: 3.425-8.419), No.3(OR=1.127, 95%CI:1.053-1.206), No.6(OR=1.221,95%CI: 1.028-1.450), No.7(OR=2.149, 95%CI: 1.711-2.699), No,11p(OR=2.085, 95%CI: 1.453-2.994), No.14v(OR=2.604, 95%CI: 1.038-6.532) group lymph nodes were the independent risk factors of No.8p lymph node metastasis. One-year, 3-year and 5-year survival rates in positive No.8p group were 85.7%, 47.5% and 22.6%, and those in negative No.8p group were 96.2%, 82.5% and 70.3% respectively, whose differences were significant (χ2=109.767, P<0.05).
  
  
  CONCLUSIONS
  Metastasis in Np.8p lymph nodes is an important factor affecting the prognosis of patients with advanced gastric cancer. In patients with female gender, tumor diameter ≥5 cm, preoperative late N staging, low tumor differentiation or metastasis in No.8a, No.3, No.6, No.7, No.11p, No.14v group lymph nodes, thorough clean rance of No.8p group lymph node should be considered.
authors.affiliation: Department of Gastrointestinal Surgery, Fujian Provincial Tumor Hospital, Fuzhou 350014, China. luchuanchen@sina.com.
authors.forename: Luchuan
authors.initials: L
authors.lastname: Chen
authors.forename: Shenhong
authors.initials: S
authors.lastname: Wei
authors.forename: Zaisheng
authors.initials: Z
authors.lastname: Ye
authors.forename: Yi
authors.initials: Y
authors.lastname: Zeng
authors.forename: Qiuhong
authors.initials: Q
authors.lastname: Zheng
authors.forename: Jun
authors.initials: J
authors.lastname: Xiao
authors.forename: Yi
authors.initials: Y
authors.lastname: Wang
authors.forename: Changhua
authors.initials: C
authors.lastname: Zhuo
authors.forename: Zhenmeng
authors.initials: Z
authors.lastname: Lin
authors.forename: Yangming
authors.initials: Y
authors.lastname: Li
mesh_terms: D002272:Carcinoembryonic Antigen / Q000097:blood; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods; D008198:Lymph Nodes / Q000503:physiopathology* / Q000601:surgery; D008207:Lymphatic Metastasis / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D015999:Multivariate Analysis; D060787:Neoplasm Grading / Q000706:statistics & numerical data; D009367:Neoplasm Staging / Q000706:statistics & numerical data; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000401:mortality* / Q000601:surgery; D015996:Survival Rate
chemical_list: D002272:Carcinoembryonic Antigen