Prognostic impact of lymph node micrometastasis in patients with gastric cancer

Purpose The clinical significance of lymph node micrometastasis (LNMM) remains controversial in gastric cancer (GC). In this study, we investigated the prognostic impact of LNMM in patients with GC. Methods A total of 624 patients with pathologically lymph node metastasis-negative (pN0) and N1 status (pN1) who underwent gastrectomy between 2004 and 2018 were enrolled in this retrospective study. The diameter of tumor cell clusters in metastatic lymph nodes was measured in 120 patients with pN1 GC. Results Patients with lymph node tumors < 1500 mu m in diameter (LNMM) had a significantly better prognosis than those with tumors >= 1500 mu m in diameter (p = 0.012; log-rank test). Cox's proportional hazards model revealed that LNMM (p = 0.016), several dissected lymph nodes (p = 0.049), and the provision of adjuvant chemotherapy (p = 0.002) were independent prognostic factors for the overall survival of patients with pN1 GC. There was no significant difference in the overall survival between patients with LNMM who received chemotherapy and those who did not (p = 0.332). Conclusions LNMM is associated with a favorable prognosis and maybe an independent prognostic marker in patients with pN1 GC. LNMM in GC may be considered a factor preventing adjuvant chemotherapy.

Automated summary

This study found that patients with lymph node micrometastasis (LNMM) <1500 μm in diameter had a better prognosis in gastric cancer, suggesting LNMM may be an independent prognostic marker in patients with pN1 GC. Additionally, LNMM may impact the effectiveness of adjuvant chemotherapy in gastric cancer patients.