Clinicopathological Factors Associated with Lymph Node Metastasis in Gastric Cancer

Öz

Abstract Aim The aim of this study was to evaluate clinicopathological factors associated with lymph node metastasis in patients undergoing surgical treatment for gastric cancer, with particular emphasis on biological invasion parameters. Methods This retrospective study included patients who underwent surgical treatment for gastric cancer between 2010 and 2020 at a single tertiary center. Patients with distant metastasis or those who received neoadjuvant therapy were excluded. Demographic, clinical, and pathological variables were recorded. Lymph node metastasis was defined as the presence of at least one metastatic lymph node. Univariate analyses were performed to identify factors associated with lymph node metastasis, followed by multivariable logistic regression analysis to determine independent predictors. Results A total of 122 patients were included. In univariate analysis, tumor diameter, number of retrieved lymph nodes, lymphovascular invasion, and perineural invasion were significantly associated with lymph node metastasis (all p < 0.05). Age, sex, body mass index, hemoglobin, and serum albumin levels were not significantly associated with lymph node metastasis. In multivariable analysis, lymphovascular invasion emerged as the only independent predictor of lymph node metastasis (odds ratio 6.91, 95% confidence interval 2.67–17.89, p < 0.001), whereas tumor diameter and perineural invasion lost statistical significance after adjustment. Conclusion Lymphovascular invasion is the strongest independent predictor of lymph node metastasis in patients undergoing surgery for gastric cancer. These findings highlight the importance of tumor biological behavior and careful pathological assessment for postoperative risk stratification. Keywords Gastric cancer, Lymph node metastasis, Lymphovascular invasion, Pathology, Risk factors

Anahtar Kelimeler

• Gastric cancer
• Lymph node metastasis
• Lymphovascular invasion
• Pathology
• Risk factors

Gastrik Kanserde Lenf Nodu Metastazı ile İlişkili Klinikopatolojik Faktörler

Öz

Özet Amaç Bu çalışmanın amacı, gastrik kanser nedeniyle cerrahi tedavi uygulanan hastalarda lenf nodu metastazı ile ilişkili klinikopatolojik faktörleri değerlendirmek ve özellikle biyolojik invazyon parametrelerine odaklanmaktır. Yöntem Bu retrospektif çalışmaya, 2010–2020 yılları arasında tek bir üçüncü basamak merkezde gastrik kanser nedeniyle cerrahi tedavi uygulanan hastalar dahil edildi. Uzak metastazı olan hastalar ve neoadjuvan tedavi alanlar çalışma dışı bırakıldı. Demografik, klinik ve patolojik veriler kaydedildi. Lenf nodu metastazı, histopatolojik incelemede en az bir metastatik lenf nodunun varlığı olarak tanımlandı. Lenf nodu metastazı ile ilişkili faktörleri belirlemek amacıyla önce tek değişkenli analizler yapıldı, ardından bağımsız prediktörleri saptamak için çok değişkenli lojistik regresyon analizi uygulandı. Bulgular Toplam 122 hasta çalışmaya dahil edildi. Tek değişkenli analizlerde tümör çapı, çıkarılan lenf nodu sayısı, lenfovasküler invazyon ve perinöral invazyon lenf nodu metastazı ile anlamlı olarak ilişkili bulundu (tümü için p < 0,05). Yaş, cinsiyet, vücut kitle indeksi, hemoglobin ve serum albümin düzeyleri ile lenf nodu metastazı arasında anlamlı ilişki saptanmadı. Çok değişkenli analizde ise lenfovasküler invazyon, lenf nodu metastazı için tek bağımsız prediktör olarak belirlendi (olasılık oranı 6,91; %95 güven aralığı 2,67–17,89; p < 0,001). Tümör çapı ve perinöral invazyon, diğer değişkenler için düzeltme yapıldıktan sonra istatistiksel anlamlılığını kaybetti. Sonuç Lenfovasküler invazyon, gastrik kanser nedeniyle cerrahi uygulanan hastalarda lenf nodu metastazının en güçlü ve tek bağımsız prediktörüdür. Bu bulgular, lenf nodu yayılımında tümör biyolojik davranışının önemini vurgulamakta ve ameliyat sonrası risk sınıflandırmasında dikkatli patolojik değerlendirmenin gerekliliğini ortaya koymaktadır. Anahtar Kelimeler Gastrik kanser, Lenf nodu metastazı, Lenfovasküler invazyon, Patoloji, Risk faktörleri

Anahtar Kelimeler

• Gastrik kanser
• Lenf nodu metastazı
• Lenfovasküler invazyon
• Patoloji
• Risk faktörleri

Kaynakça

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