The number of mesogastria containing metastatic lymph nodes predicts gastric cancer prognosis

• Published in: Surgery 2024-09, Vol.176 (3), p.739-747
• Main Authors: Tu, Jianjian, Shao, Shengli, Qin, Jichao
• Format: Article
• Language: English
• Subjects: Adult; Aged; Female; Gastrectomy; Humans; Kaplan-Meier Estimate; Lymph Node Excision; Lymph Nodes - pathology; Lymphatic Metastasis - pathology; Male; Mesentery - pathology; Middle Aged; Neoplasm Staging; Prognosis; Stomach Neoplasms - mortality; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery
• ISSN: 0039-6060; 1532-7361; 1532-7361
• DOI: 10.1016/j.surg.2024.05.027

Previous studies have established the existence of the mesogastrium, dividing it into 6 sections. The mesogastrium is identified during surgery and used in surgical practice. The aim of the present study was to further investigate its role in gastric cancer prognosis. Between January 2014 and January 2018, patients from the Tongji Hospital were included in this post hoc analysis, including data from a randomized clinical study (DCGC01; http://www.clinicaltrials.gov, NCT01978444). Mesogastria containing metastatic lymph nodes were referred to as metastatic mesogastria. Pathology reports were examined to assess metastases in the mesogastrium. Survival was assessed using Kaplan–Meier curves and multivariable Cox models. Among the 479 patients, 230 (48.0%) had no lymph node metastasis, 34 (7.1%) had 1 metastatic mesogastrium, and 215 (44.9%) had 2 to 6 metastatic mesogastria. Multivariate analysis showed that the number of metastatic mesogastria and N stages were independent risk factors for patient prognosis. In general, a higher metastatic mesogastrium number is positively correlated with a worse prognosis. For identical N stages, 5-year survival rates for patients with 2 to 6 metastatic mesogastria were significantly lower than those for patients with 1 metastatic mesogastrium. The number of metastatic mesogastria serves as an independent prognostic factor from the N stage.