P-101 - Tumor differentiation is a risk factor for lymph node metastasis in patients with gastric cancer

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Gastric Cancer
Pathology/Molecular Biology
Presenter D. Klimas
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors D. Klimas, A. Baušys, A. Kilius, K. Pauža, G. Rudinskaite˙, Ž. Sinkevičius, N. Samalavičius, E. Sangaila, R. Baušys
  • Faculty of Medicine, Vilnius/LT

Abstract

Introduction

The absence or presence of lymph node metastasis must be confirmed for developing an optimal treatment strategy for gastric cancer. Radiological imaging does not always respond to this question. This study aimed to determine the predictive risk factors for lymph node metastasis.

Methods

All patients who underwent surgical treatment for gastric cancer in National Cancer Institute between 2013–2014 were retrospectively analyzed. Univariate analyses and multivariate logistic regression analyses were performed to identify predictors for lymph node metastasis (LNM). Non-parametric tests were used for the univariate analyses. Categorical variables (sex, smoking status, alcoholism, blood type according to AB0 and RhD antigens, primary tumor invasion, tumor differentiation grade, lymphovascular invasion, tumor localisation) and continuous variables (age, BMI) were assessed to identify risk factors. Multivariate logistic regression analysis was then performed to evaluate the independent predictors for LNM. A probability value less than 0.05 was considered statistically significant.

Results

This study included 229 patients, mean age was 66,43 ± 12,07, and 61% were male. According to histologic evaluation, the number of patients with lymph node metastasis was 140 (61,1%). Average number of involved lymph nodes – 10,20 ± 10,61. Univariate analysis of potential risk factors for lymph node metastasis revealed that size of primary tumor (TIS - 0%, T1 – 16,1%, T2 – 56,7%, T3 – 75,0%, T4 – 92,1%, p < 0,05), lymphovascular invasion (92,0% vs 42, 0%, p < 0,05), tumor localisation in upper third (73,6% vs 54,9%, p < 0,05) and poorly differentiated (G3) tumors (71,6% vs 50,6% vs 18,2%, p < 0,05) were significantly associated lymph node metastasis. Multivariate analysis showed that poorly differentiated (G3) tumors (OR – 2,41, 95% CI 1,41-3,89, p < 0,05) and lymphovascular invasion (OR – 16,00, 95% CI 6,78-37,76, p < 0,05) are independent risk factors for lymph node metastasis.

Conclusion

This study provided additional information about the factors suitable for predicting metastasis in lymph nodes for patients with gastric cancer. Poorly differentiated tumors and lymphovascular invasion is independent risk factors. Knowledge of these factors may be important in selecting the most appropriate individual treatment strategy for every patient.