Mide kanseri nedeniyle D2 lenf nodu diseksiyonu yapılan hastalarda metastatik lenf nodu oranının (MLNR) prognostik değeri

Öz

Amaç: Bu çalışmanın amacı, küratif D2 lenf nodu diseksiyonu uygulanan mide kanseri hastalarında metastatik lenf nodu oranı (MLNR) evrelemesinin prognostik değerini araştırmaktır. Yöntemler: Ocak 2012 ile Nisan 2021 arasında klinik olarak lokal ileri mide kanseri nedeniyle küratif gastrektomi ve D2 lenf nodu diseksiyonu uygulanan 171 hastanın kayıtları geriye dönük olarak incelendi. Metastatik lenf nodu oranı (MLNR) ve Tümör Lenf Nodu Metastazı ( TNM ) evreleme sistemine göre lenf nodu (N) evrelemesi değerlendirildi. Genel sağ kalım (OS), hastalıksız sağkalım (DFS), klinikopatolojik özellikler ve prognostik faktörler değerlendirildi. MLNR, lenf nodu metastazı sayısı ile karşılaştırıldı. Bulgular: Çalışmaya dahil edilen hastaların ortalama yaşı 60.7 idi (erkek: N = 118; kadın: N = 53). TNM, N evrelemesine göre, 62 hasta N0, 25 hasta N1, 35 hasta N2 ve 49 hasta N3 idi. MLNR evrelemesine göre MLNR 0 62 hasta, MLNR 1 35 hasta, MLNR 2 35 hasta ve MLNR 3 grubunda 39 hasta vardı. MLNR evrelemesine göre 32 hastada (% 18,7) evre kayması görüldü. Cox regresyon sağkalım analizi, MLNR'nin bağımsız bir prognostik faktör olduğunu gösterdi. Sonuç: Nodal değerlendirmede pozitif lenf nodu sayısı yerine MLNR evrelemesinin kullanılması, evre kayması sorununu azaltmaya yardımcı olabileceği bulunmuştur. MLNR, hem OS hem de DFS için önemli bir prognostik faktördür.

Anahtar Kelimeler

• mide kanseri
• lenf nodu metastazı
• metastatik lenf nodu oranı
• prognoz
• evre kayması

Prognostic Value of Metastatic Lymph Node Ratio (MLNR) in Patients Undergoing D2 Gastrectomy for GastricCancer

Abstract

Aim: Aim of this study was to investigate the prognostic value of metastatic lymph node ratio (MLNR) staging in gastric cancer patients who underwent curative D2 lymph node dissection. Place and Duration of Study: Department of General Surgery, University of Health Sciences, Prof Dr Cemil Tascıoğlu City Hospital, Istanbul, Turkey, from January 2012 to April 2021. Methods: Medical records of 171 patients undergoing D2 curative gastrectomy for locally advanced gastric cancer between January 2012 and April 2021 were reviewed retrospectively. Metastatic lymph node ratio (MLNR) and TNM staging system node ( Ns )staging was evaluated. Prognostic factors on overall and disease-free survival (DFS) were evaluated. MLNR was compared with number of lymph node metastasis. Results: Mean age of patients included in present study was 60.7 (male: N = 118; female: N = 53). Based on TNM N staging, 62 patients N0, 25 patients N1, 35 patients N2, and 49 were N3 patients. According to classification based on metastatic lymph node ratio (MLNR), 62 patients MLNR 0, 35 patients MLNR 1, 35 patients MLNR 2 and 39 patients were in the MLNR 3 group. Stage migration were seen in 32 patients ( % 18,7 ) in the classification of MLNR. Cox regression survival analysis showed MLNR is an independent prognostic factor. Conclusions: It has been found that using MLNR staging instead of number of positive lymph nodes in nodal evaluation can help to reduce the problem of stage migration. MLNR is an important prognostic factor for both OS and DFS.

Keywords

• Gastric cancer
• Lymph node metastasis
• Metastatic lymph node ratio
• Prognosis
• Stage migration

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