Swollen lymph node metastasis and survival in gastric cancer: Multi-institutional post-resection analysis

Table 1 Clinicopathological features of gastric cancer patients according to the status of swollen lymph node metastasis, data is reported for the whole study series and for the matched pairs, n (%)

Characteristics	Whole study series			Matched pairs (case-control method)
	SLNM positive (n = 368)	SLNM negative (n = 139)	P value	SLNM positive (n = 133)	SLNM negative (n = 133)	P value
Sex			0.900			0.683
Male	99 (71.2)	260 (70.7)		97 (72.9)	94 (70.7)
Female	40 (28.8)	108 (29.3)		36 (27.1)	39 (29.3)
Age (years)			0.132			0.496
< 70	104 (74.8)	250 (67.9)		98 (73.7)	93 (69.9)
≥ 70	35 (25.2)	118 (32.1)		35 (26.3)	40 (30.1)
Preoperative tumor marker			< 0.001			0.695
Normal	90 (64.7)	297 (80.7)		88 (66.2)	91 (68.4)
Elevated	49 (35.3)	71 (19.3)		45 (33.8)	42 (31.6)
Tumor location			< 0.001			0.130
Lower one-third	46 (33.1)	126 (34.2)		44 (33.1)	38 (28.6)
Middle one-third	21 (15.1)	53 (14.4)		19 (14.3)	23 (17.3)
Upper one-third	27 (19.4)	140 (38.0)		27 (20.3)	41 (30.8)
2/3 or more	45 (32.4)	49 (13.3)		43 (32.3)	31 (23.3)
Tumor size			0.007			0.891
< 5 cm	38 (27.3)	148 (40.2)		36 (27.1)	37 (27.8)
≥ 5 cm	101 (72.7)	220 (59.8)		97 (72.9)	96 (72.2)
Borrmann type			< 0.001			0.061
I, II	33 (23.7)	155 (42.1)		33 (24.8)	47 (35.3)
III, IV	106 (76.3)	213 (57.9)		100 (75.2)	86 (64.7)
Histology			0.013			0.769
Differentiated	29 (20.9)	118 (32.1)		29 (21.8)	31 (23.3)
Undifferentiated	110 (79.1)	250 (67.9)		104 (78.2)	102 (76.7)
T stage			< 0.001			0.290
T1	2 (1.4)	16 (4.3)		2 (1.5)	0 (0.0)
T2	2 (1.4)	29 (7.9)		2 (1.5)	4 (3.0)
T3	7 (5.0)	53 (14.4)		7 (5.3)	12 (9.0)
T4a	115 (82.7)	252 (68.5)		111 (83.5)	102 (76.7)
T4b	13 (9.4)	18 (4.9)		11 (8.3)	15 (11.3)
N stage			< 0.001			0.977
N1	13 (9.4)	136 (37.0)		13 (9.8)	12 (9.0)
N2	49 (35.3)	125 (34.0)		49 (36.8)	49 (36.8)
N3	77 (55.4)	107 (29.1)		71 (53.4)	72 (54.1)
Tumor deposits			0.039			0.689
Negative	94 (67.6)	282 (76.6)		91 (68.4)	94 (70.7)
Positive	45 (32.4)	86 (23.4)		42 (31.6)	39 (29.3)
Lymphovascular invasion			< 0.001			0.122
Negative	83 (59.7)	294 (79.9)		81 (60.9)	93 (69.9)
Positive	56 (40.3)	74 (20.1)		52 (39.1)	40 (30.1)
Type of gastrectomy			0.036			0.454
Subtotal	79 (56.8)	246 (66.8)		76 (57.1)	82 (61.7)
Total	60 (43.2)	122 (33.2)		57 (42.9)	51 (38.3)

SLNM: Swollen lymph node metastasis.

Table 2 The univariate and multivariate survival analyses of patients with gastric cancer

Variables	n	5-year overall survival (%)	Univariate analysis		Multivariate analysis
			χ² value	P value	Hazard ratio (95%CI)	P value
Sex			2.743	0.098
Male	359	27.1
Female	148	36.1
Age (years)			10.663	0.001
< 70	354	33.7			1 (Reference)
≥ 70	153	20.4			1.478 (1.178-1.856)	0.001
Preoperative tumor marker			13.180	< 0.001
Normal	387	33.5			1 (Reference)
Elevated	120	17.4			1.339 (1.046-1.713)	0.020
Tumor location			31.899	< 0.001
Lower one-third	172	37.6			1 (Reference)
Middle one-third	74	30.6			1.412 (0.977-2.040)	0.066
Upper one-third	167	29.0			1.443 (1.091-1.909)	0.010
2/3 or more	94	16.7			1.543 (1.090-2.182)	0.014
Tumor size			17.164	< 0.001
< 5 cm	186	40.0			1 (Reference)
≥ 5 cm	321	23.7			1.248 (0.992-1.569)	0.058
Borrmann type			17.506	< 0.001
I, II	188	38.3			1 (Reference)
III, IV	319	24.5			1.352 (1.070-1.707)	0.011
Histology			7.512	0.006
Differentiated	147	38.4			1 (Reference)
Undifferentiated	360	26.2			1.156 (0.904-1.480)	0.248
Depth of invasion
T1	18	88.5	81.327	< 0.001	1 (Reference)
T2	31	79.5			1.480 (0.377-5.815)	0.575
T3	60	45.7			4.344 (1.313-14.367)	0.016
T4a	367	21.4			7.788 (2.440-24.855)	0.001
T4b	31	12.1			9.456 (2.779-32.171)	< 0.001
N stage			77.324	< 0.001
N1	149	48.2			1 (Reference)
N2	174	32.5			1.448 (1.061-1.976)	0.020
N3	184	11.9			1.624 (1.206-2.187)	0.001
Tumor deposits			9.634	0.002
Negative	376	31.7			1 (Reference)
Positive	131	24.1			1.279 (0.999-1.637)	0.051
Lymphovascular invasion			12.039	< 0.001
Negative	377	34.2			1 (Reference)
Positive	130	16.4			1.356 (10.68-1.722)	0.012
Type of gastrectomy			7.213	0.007
Subtotal	325	32.4			1 (Reference)
Total	182	25.0			1.018 (0.789-1.314)	0.890
Swollen lymph node metastasis			45.585	< 0.001
Absent	368	35.8			1 (Reference)
Present	139	13.6			1.318 (1.026-1.695)	0.031

Ref: Reference.

Table 3 Stratified analysis according to N stage

N stage	SLNM positive		SLNM negative		χ² value	P value
	n	5-year OS (%)	n	5-year OS (%)
N1	136	50.0	13	30.8	4.131	0.042
N2	125	36.7	59	21.8	7.535	0.006
N3	107	16.5	77	5.8	9.376	0.002

OS: overall survival; SLNM: Swollen lymph node metastasis.

Table 4 Multivariate survival analysis of gastric cancer patients with swollen lymph node metastasis

Variables	Hazard ratio	95%CI	P value
T stage (T4 vs T1-3)	2.526	2.098-5.813	0.029
N stage (N3 vs N1-2)	1.722	1.176-2.522	0.005
Tumor deposits (positive vs negative)	1.394	0.948-2.048	0.091
Neoadjuvant chemotherapy (yes vs no)	0.626	0.429-0.916	0.016