Effect of standardized lymph node sorting on surgical treatment of gastroesophageal junction malignant tumors
10.19405/j.cnki.issn1000-1492.2024.08.026
- Author:
Huihu He
1
;
Kaiji Gao
2
;
Jiahe Sun
2
;
Qiyang Yao
1
;
Shijie Zhang
1
;
Lingjun Geng
1
Author Information
1. Dept of General Surgery，Fuyang Hospital of Anhui Medical University，Fuyang 236000
2. Dept of Oncology，The First Affiliated Hospital of Bengbu Medical University，Bengbu 233004
- Publication Type:Journal Article
- Keywords:
esophagogastric junction malignant tumor;
lymph node sorting;
survival period;
propensity matching
- From:
Acta Universitatis Medicinalis Anhui
2024;59(8):1465-1470
- CountryChina
- Language:Chinese
-
Abstract:
Objective :To investigate the effect of standardized lymph node sorting on postoperative results of gas- troesophageal junction malignant tumors．
Methods :The data of all patients with malignant gastroesophageal junc- tion in gastric cancer database were analyzed retrospectively．Lymph nodes were sorted according to whether sur- geons were present immediately after surgery．Patients were divided into lymph node sorting group (sorting group) and lymph node unsorting group (unsorting group) ．General data included gender，age，body mass index (BMI) ， carcinogenic antigen ( CEA) ，postoperative albumin level，preoperative hemoglobin，etc．Perioperative and patho- logical data included operation time，intraoperative blood loss，postoperative hospital stay，tumor differentiation， distance from superior incisal margin，total number of lymph nodes，number of positive lymph nodes，etc．Kaplan- Meier curve and Log-rank test were used for survival analysis，and propensity score matching analysis adjusted for confounding factors between groups.
Results :A total of 386 patients were included，including 133 in lymph node sorting group and 253 in non-sorting group．The median follow-up time was 40. 18 months．The total number of lymph nodes and the number of positive lymph nodes in the sorting group were (26. 38 ± 12. 18) and (6. 63 ± 10. 14) ，respectively，while the total number and the number of positive lymph nodes in the non-sorting group were ( 12. 25 ± 7. 06) and (3. 07 ± 3. 77) ，respectively．There were statistically significant differences in the total num- ber of lymph nodes and the number of positive lymph nodes between the sorting group and the non-sorting group (P ＜0. 05) ．There was no statistically significant difference in survival between the sorting group and the non-sorting group before matching．There were 112 and 203 patients with advanced gastric cancer in the two groups，respec- tively．The overall survival curve of patients in the sorting group was better than that in the non-sorting group，and the difference in median survival time was statistically significant (P＜0. 05) ．The caliper value was set to 0. 02， and 94 pairs of patients were preferentially matched．After matching，the total number of lymph nodes and the num- ber of positive lymph nodes in the sorting group were (24. 71 ± 12. 03) and (5. 70 ± 9. 95) ，respectively，while the total number and the number of positive lymph nodes in the non-sorting group were ( 13. 05 ± 7. 63) and (3. 37 ± 4. 32) ，respectively．The difference between the two groups was statistically significant (P＜0. 05) ．The overall survival curve of patients in the sorting group was better than that in the non-sorting group，and the median survival time was statistically significant (P＜0. 05) ．
Conclusion :Postoperative lymph node sorting for gastric cancer can significantly increase the number of total lymph nodes and positive lymph nodes，reduce lymph node migration，and improve postoperative survival time.
- Full text:202409141610037565规范化淋巴结分拣对胃食管结合部恶性肿瘤手术治疗的效果_何辉虎.pdf
