Brief Article
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World J Gastroenterol. Oct 7, 2013; 19(37): 6245-6257
Published online Oct 7, 2013. doi: 10.3748/wjg.v19.i37.6245
Lymph node metastasis in gastric cardiac adenocarcinoma in male patients
Gang Ren, Ying-Wei Chen, Rong Cai, Wen-Jie Zhang, Xiang-Ru Wu, Ye-Ning Jin
Gang Ren, Department of Radiology, Xin Hua Hospital, Shanghai Jiaotong University Medical School, Shanghai 200092, China
Ying-Wei Chen, Department of Gastroenterology, Xin Hua Hospital, Shanghai Jiaotong University Medical School, Shanghai 200092, China
Rong Cai, Ye-Ning Jin, Department of Radiochemotherapy, Rui Jin Hospital, Shanghai Jiaotong University Medical School, Shanghai 200092, China
Wen-Jie Zhang, Department of Surgery, Xin Hua Hospital, Shanghai Jiaotong University Medical School, Shanghai 200092, China
Xiang-Ru Wu, Department of Pathology, Xin Hua Hospital, Shanghai Jiaotong University Medical School, Shanghai 200092, China
Author contributions: Ren G and Chen YW contributed equally to this paper and performed the data acquisition, analysis, and interpretation; Zhang WJ, Jin YN and Wu XR performed data acquisition; Cai R designed the study and wrote the manuscript.
Supported by Shanghai Jiaotong University Medical School for Scientific Research, Grants No.09XJ21013; Shanghai Health Bureau for Scientific Research, Grants No.2010029 and 2010057; Shanghai Science and Technology Commission for Scientific Research, Grants No.124119a0300; and Shanghai Municipal Education Commission, Grants No.12Y2034
Correspondence to: Rong Cai, MD, Department of Radiochemotherapy, Rui Jin Hospital, Shanghai Jiaotong University Medical School, 197 Ruijin Road, Shanghai 200092, China. cr11512@rjh.com.cn
Telephone: +86-21-64370045 Fax: +86-21-64378715
Received: May 1, 2013
Revised: June 18, 2013
Accepted: July 17, 2013
Published online: October 7, 2013
Abstract

AIM: To reveal the clinicopathological features and risk factors for lymph node metastases in gastric cardiac adenocarcinoma of male patients.

METHODS: We retrospective reviewed a total of 146 male and female patients with gastric cardiac adenocarcinoma who had undergone curative gastrectomy with lymphadenectomy in the Department of Surgery, Xin Hua Hospital and Rui Jin Hospital of Shanghai Jiaotong University Medical School between November 2001 and May 2012. Both the surgical procedure and extent of lymph node dissection were based on the recommendations of Japanese gastric cancer treatment guidelines. Univariate and multivariate analyses of lymph node metastases and the clinicopathological features were undertaken.

RESULTS: The rate of lymph node metastases in male patients with gastric cardiac adenocarcinoma was 72.1%. Univariate analysis showed an obvious correlation between lymph node metastases and tumor size, gross appearance, differentiation, pathological tumor depth, and lymphatic invasion in male patients. Multivariate logistic regression analysis revealed that tumor differentiation and pathological tumor depth were the independent risk factors for lymph node metastases in male patients. There was an obvious relationship between lymph node metastases and tumor size, gross appearance, differentiation, pathological tumor depth, lymphatic invasion at pN1 and pN2, and nerve invasion at pN3 in male patients. There were no significant differences in clinicopathological features or lymph node metastases between female and male patients.

CONCLUSION: Tumor differentiation and tumor depth were risk factors for lymph node metastases in male patients with gastric cardiac adenocarcinoma and should be considered when choosing surgery.

Keywords: Gastric neoplasm, Lymph node metastasis, Risk factors, Gastrectomy, Lymphadenectomy

Core tip: There is an obvious correlation between lymph node metastases and tumor size, gross appearance, differentiation, pathological tumor depth and lymphatic invasion in male patients. Tumor differentiation and pathological tumor depth were independent risk factors for lymph node metastases in male patients. There was an obvious relationship between lymph node metastases and tumor size, gross appearance, differentiation, pathological tumor depth, lymphatic invasion at pN1 and pN2, and nerve invasion at pN3 in male patients. There were no significant differences in clinicopathological features or lymph node metastases between female and male patients.