Fatma YALÇIN MÜSRİ, Ahmet BİLİCİ, Melek KARAKURT ERYILMAZ, Özgür Cem MÜSRİ, Gökhan TAZEGÜL, Selver IŞIK, Mehmet KAPLAN

Mide Kanserinde Pozitif Lenf Nodu Oranının Prognostik Önemi

Bu çalışmada, evre 1-3 gastrik karsinomda (GK) metastatik lenf nodlarının toplam çıkarılan lenf nodu sayısına oranının (LNO) prognostik önemini değerlendirmeyi amaçladık. 2012-2019 yılları arasında opere edilen evre 1-3 GK’lı toplam 233 hasta retrospektif olarak değerlendirildi. Sağkalım eğrileri Kaplan-Meier yöntemi kullanılarak oluşturuldu. Medyan metastatik ve disseke lenf nodu sayısı sırasıyla 5 ve 27 idi, ortalama LNO 0.1 idi. Hastalar LNO <0.1 ve ≥0.1 olanlar olmak üzere iki gruba ayrıldı. Medyan LNO <0.1 ve ≥0.1 olan hastalarda medyan genel sağkalım 26.9 ay ve 76 ay idi (p <0.001). Tek değişkenli analizde cinsiyet, lenfovasküler invazyon (LVİ) ve perinöral invazyon (PNİ) medyan genel sağkalımda anlamlı bulundu (sırasıyla p=0.043, <0.001 ve <0.001). LNO ve LVİ, çok değişkenli analizde genel sağkalımın bağımsız prediktörleri olarak saptandı (sırasıyla p<0.01 ve 0.02). GK hastalarında artan LNO, opere edilen hastalarda azalmış genel sağkalım açısından prognostik bir öneme sahiptir. Bu nedenle, LNO, yetersiz lenf nodu diseksiyonu veya D1 diseksiyonu olan hastalarda patolojik nodal sınıflandırma yerine kullanılabilir.

Anahtar Kelimeler:

mide kanseri, lenf nodu oranı, genel sağkalım

Prognostic Importance of the Positive Lymph Node Ratio in the Gastric Cancer

Herein, we aimed to evaluate the prognostic significance of the ratio of metastatic lymph nodes to the total number of removed lymph nodes (LNR) in Stage 1-3 operated gastric carcinoma (GC). A total of 233 patients with stage 1-3 GC operated between 2012 and 2019 were retrospectively evaluated. Survival curves were constructed using the Kaplan-Meier method. The median number of metastatic and dissected lymph nodes were 5 and 27, respectively, with a median LNR of 0.1. Patients were categorized into two groups as those with a LNR <0.1 and ≥0.1. Median OS in patients with a median LNR of <0.1 and ≥0.1 were 76 vs. 26.9 months (p<0.001). In univariate analysis gender, lymphovascular invasion (LVI), and perineural invasion (PNI) were found to be significant predictors of median OS (p=0.043, <0.001 and <0.001, respectively). LNR and LVI emerged as independent predictors of OS in the multivariate analyses (p<0.01 and 0.02, respectively). LNR has prognostic significance for OS in operated GC patients where increasing LNR is associated with reduced overall survival. Thus, LNR may be used as a substitute for pathological nodal classification in patients with insufficient lymph node dissection or D1 dissection.

Keywords:

gastric cancer, lymph node ratio, overall survival,

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