Dong YP, Cai FL, Wu ZZ, Wang PL, Yang Y, Guo SW, Zhao ZZ, Zhao FC, Liang H, Deng JY. Risk of station 12a lymph node metastasis in patients with lower-third gastric cancer. World J Gastrointest Surg 2021; 13(11): 1390-1404 [PMID: 34950428 DOI: 10.4240/wjgs.v13.i11.1390]
Corresponding Author of This Article
Jing-Yu Deng, MD, PhD, Chief Doctor, Professor, Department of Gastroenterology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy at Tianjin, Tianjin’s Clinical Research Center for Cancer, Huanhuxi Road, Hexi District, Tianjin 300060, China. dengery@126.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Nov 27, 2021; 13(11): 1390-1404 Published online Nov 27, 2021. doi: 10.4240/wjgs.v13.i11.1390
Risk of station 12a lymph node metastasis in patients with lower-third gastric cancer
Yin-Ping Dong, Feng-Lin Cai, Zi-Zhen Wu, Peng-Liang Wang, Yang Yang, Shi-Wei Guo, Zhen-Zhen Zhao, Fu-Cheng Zhao, Han Liang, Jing-Yu Deng
Yin-Ping Dong, Feng-Lin Cai, Zi-Zhen Wu, Peng-Liang Wang, Shi-Wei Guo, Zhen-Zhen Zhao, Fu-Cheng Zhao, Han Liang, Jing-Yu Deng, Department of Gastroenterology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy at Tianjin, Tianjin’s Clinical Research Center for Cancer, Tianjin 300060, China
Yang Yang, Department of Anesthesiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy at Tianjin, Tianjin’s Clinical Research Center for Cancer, Tianjin 300060, China
Author contributions: Dong YP and Cai FL contributed equally to this work; Dong YP contributed to project development, data analysis, and manuscript writing and editing; Wu ZZ and Zhao ZZ contributed to project development; Cai FL, Wang PL, Yang Y, Guo SW, and Zhao FC contributed to data collection or management; Liang H contributed to protocol development and data collection or management; Deng JY contributed to protocol/project development, data collection or management, data analysis, and manuscript writing and editing.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Tianjin Medical University Cancer Institute and Hospital.
Informed consent statement: All eligible patients delivered written informed consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jing-Yu Deng, MD, PhD, Chief Doctor, Professor, Department of Gastroenterology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy at Tianjin, Tianjin’s Clinical Research Center for Cancer, Huanhuxi Road, Hexi District, Tianjin 300060, China. dengery@126.com
Received: April 7, 2021 Peer-review started: April 7, 2021 First decision: June 14, 2021 Revised: July 6, 2021 Accepted: October 24, 2021 Article in press: October 24, 2021 Published online: November 27, 2021 Processing time: 233 Days and 9.9 Hours
ARTICLE HIGHLIGHTS
Research background
Controversy over the issue that station 12a lymph node involvement is distant or regional metastasis remains, and whether station 12a lymph nodes should be included in D2 lymphadenectomy or not is unclear.
Research motivation
To investigate the risk factors for station 12a lymph node metastasis and evaluate the survival outcomes of station 12a lymph node dissection in patients with lower-third gastric cancer (GC).
Research objectives
To investigate whether the clinicopathological factors and metastasis status of other perigastric lymph nodes can predict station 12a lymph node metastasis and evaluate the prognostic significance of station 12a lymph node dissection in patients with lower-third GC.
Research methods
Survival prognoses were compared between patients with or without station 12a lymph node metastasis. Logistic regression analyses were used to clarify the association between station 12a lymph node metastasis and clinicopathological factors or metastasis status of other perigastric lymph nodes.
Research results
The incidence of station 12a lymph node involvement was reported as 12.2% in patients with lower-third GC. The overall survival of patients without station 12a lymph node metastasis was significantly better than that of patients with station 12a lymph node metastasis (P < 0.001), which could also be seen in patients with or without extranodal soft tissue invasion. Advanced pN stage was defined as an independent risk factor significantly correlated with station 12a lymph node positivity. Station 3 lymph node status was also proven to be significantly correlated with station 12a lymph node involvement.
Research conclusions
The dissection of station 12a lymph nodes may not be ignored in D2 or D2+ lymphadenectomy due to difficulties in predicting station 12a lymph node metastasis.
Research perspectives
Controversy over the issue that station 12a lymph node involvement is distant or regional metastasis remains, and the possible inclusion of station 12a lymph nodes in the D2 lymphadenectomy is unclear. As reported, GC located in the lower third was highly related to the metastasis of station 12a lymph nodes. The clinicopathological factors related to station 12a lymph node metastasis in patients with lower-third GC were investigated in this study. The results showed that station 3 lymph node status was highly related to station 12a lymph node metastasis. The poor prognosis of patients with station 12a lymph node metastasis compared with those without indicated that station 12a lymph node dissection must be considered. This study further validated the significance of the study of station 12a lymph node metastasis in patients with lower third GC.
