A Pilot Study of Prognostic Value of Metastatic Lymph Node Count and Size in Patients with Different Stages of Gastric Carcinoma

Abstract

Yong Gao,1,2,* Kun Wang,3,* Xiao-Xian Tang,2 Jin-Liang Niu,4 Jun Wang1 1Department of Medical Imaging, Shanxi Medical University, Taiyuan, 030001, People’s Republic of China; 2Department of Radiology, Shanxi Provincial People’s Hospital, Taiyuan, 030012, People’s Republic of China; 3Department of Hepatopathy, Third People Hospital of Taiyuan City, Taiyuan, 030001, People’s Republic of China; 4Department of Radiology, 2nd Hospital, Shanxi Medical University, Taiyuan, 030001, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jun Wang, Department of Medical Imaging, Shanxi Medical University, Taiyuan, 030001, People’s Republic of China, Tel [phone], Fax [phone], Email [email protected]: The correlation between the preoperative lymph node count (LNC) on multidetector computed tomography (MDCT) and the prognosis of gastric carcinoma (GC) remains to be defined. This research aims to evaluate the prognostic value of LNC on MDCT in GC patients based on tumor-node-metastasis (TNM) staging, using different size criteria for counting.Methods: The clinical data of 126 patients with gastric adenocarcinoma undergoing gastrectomy were retrospectively analyzed. Lymph nodes greater than 8mm and 5mm on MDCT were counted and recorded. The prognostic implications of LNC on MDCT for patient survival were analyzed according to different size criteria for counting and tumor TNM staging.Results: When 8mm was used as the counting criterion, LNC on MDCT had no significant effect on the overall survival (OS) of the entire cohort. In addition, the OS of T1–T2 GC patients with LNC on MDCT ≥ 1 was significantly worse than that of patients with LNC on MDCT 7 showed a significantly worse OS than those with LNC on MDCT ≤ 7. LNC on MDCT > 7 with 5mm as the counting criterion and Stage III were independent risk factors for adverse prognosis.Conclusion: The prognostic value of LNC on MDCT based on different size criteria varies in patients with different stages of GC. LNC of a smaller size (5mm) on MDCT may be a prognostic factor for patients with relatively advanced GC.Keywords: gastric carcinoma, patient survival, lymph nodes, computed tomography

Keywords

• gastric carcinoma
• patient survival
• lymph nodes
• computed tomography