Lymph node metastasis in gastric cardiac adenocarcinoma in male patients

doi:10.3748/wjg.v19.i37.6245

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Oct 7, 2013 (publication date) through Mar 6, 2025

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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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

Table 1 Demographics and clinicopathological features of gastric cardiac adenocarcinoma

Factors	Sex		P value
Factors	Total (n = 146)	Female (n = 35)	P value	Male (n =111)
Age (yr)				0.668
< 60	46	10	36
≥ 60	100	25	75
Type of gastrectomy				0.776
Total	53	12	41
Proximal gastrectomy	93	23	70
Splenectomy				0.102
Presence	8	0	8
Absence	138	35	103
Tumor size (cm)				0.717
< 2	2	0	2
2-5	93	23	70
> 5	51	12	39
Gross appearance				0.931
Type 0	6	2	4
Type 1	13	3	10
Type 2	105	26	79
Type 3	13	2	11
Type 4	9	2	7
Tumor differentiation				0.389
Differentiated	76	16	60
Undifferentiated	70	19	51
Lymph nodes retrieved	22.88 ± 9.162	23.06 ± 9.449	22.78 ± 9.089	0.602
Pathological tumor depth				0.729
T1	8	2	6
T2	16	2	14
T3	4	1	3
T4	118	30	88
Node status (TNM)				0.665
pN₀	43	11	32
pN₁	27	4	23
pN₂	29	8	21
pN₃	47	12	35
pTNM staging				0.445
I	15	2	13
II	37	11	26
III	94	22	72
IV
Lymphatic invasion				0.694
Positive	24	5	19
Negative	122	30	92
Venous invasion				0.393
Positive	5	2	3
Negative	141	33	108
Nerve invasion				0.350
Positive	22	7	15
Negative	124	28	96
Esophageal involvement				0.497
Presence	31	6	25
Absence	115	29	86

TNM: Tumour, node, metastasis.

Table 2 Univariable analysis of lymph nodes metastasis in gastric cardiac cancer and clinicopathological factors

Factors	Total (n = 146)			Female (n = 35)			Male (n = 111)
Factors	LN+	LN-	P value	LN+	LN-	P value	LN+	LN-	P value
Age (yr)			0.927			0.134			0.353
< 60	33	13		5	5		28	8
≥ 60	71	29		19	6		52	23
Tumor size (cm)			0.011			0.554			0.011
< 2	0	2		0	0		0	2
2-5	62	31		15	8		47	23
> 5	42	9		9	3		33	6
Gross appearance			0.000			0.211			0.000
Type 0	0	6		0	2		0	4
Type 1	5	8		2	1		3	7
Type 2	82	23		19	7		63	16
Type 3	10	3		2	0		8	3
Type 4	7	2		1	1		6	1
Tumor differentiation			0.000			0.150			0.000
Differentiated	44	32		9	7		35	25
Undifferentiated	60	10		15	4		45	6
Pathological tumor depth			0.000			0.051			0.000
T1	1	7		0	2		1	5
T2	8	8		2	0		6	8
T3	3	1		0	1		3	0
T4	92	26		22	8		70	18
Lymphatic invasion			0.001			0.102			0.003
Positive	24	0		5	0		19	0
Negative	80	42		19	11		61	31
Venous invasion			0.659			0.324			0.832
Positive	4	1		2	0		2	1
Negative	100	41		22	11		78	30
Nerve invasion			0.966			0.856			0.972
Positive	15	6		5	2		11	4
Negative	88	36		19	9		69	27
Esophageal involvement			0.192			0.912			0.131
Presence	25	6		4	2		21	4
Absence	79	36		20	9		59	27

Table 3 Univariate analysis of lymph node metastases in gastric cardiac adenocarcinoma and clinicopathological factors for sex differance

Factors	Female LN+ (n = 24)	Male LN+ (n = 80)	P value
Age (yr)			0.191
< 60	15.20%	84.80%
≥ 60	26.80%	73.20%
Tumor size (cm)			0.743
< 2	0.00%	0.00%
2-5	24.20%	75.80%
> 5	21.40%	78.60%
Gross appearance			0.961
Type 0	0.00%	0.00%
Type 1	40.00%	60.00%
Type 2	23.20%	76.80%
Type 3	20.00%	80.00%
Type 4	14.30%	85.70%
Tumor differentiation			0.587
Differentiated	20.50%	79.50%
Undifferentiated	25.00%	75.00%
Pathological tumor depth			0.627
T1	0.00%	100.00%
T2	25.00%	75.00%
T3	0.00%	100.00%
T4	23.90%	76.10%
Lymphatic invasion			0.766
Positive	20.80%	79.20%
Negative	23.80%	76.20%
Venous invasion			0.192
Positive	50.00%	50.00%
Negative	22.00%	78.00%
Nerve invasion			0.399
Positive	31.30%	68.70%
Negative	21.60%	78.40%
Esophageal involvement			0.335
Presence	16.00%	84.00%
Absence	25.30%	74.70%

Table 4 Multivariate analysis of lymph node metastases in gastric cardiac cancer for the entire study population

Multivariate analysis	B	SE	χ²value	P value	OR	95%CI
Multivariate analysis						Lower	Upper
Entire study population
Tumor size	0.010	0.528	0.000	0.985	0.010	0.359	2.843
Gross appearance	-0.169	1.166	0.021	0.885	0.845	0.086	8.302
Tumor differentiation	1.806	0.522	11.981	0.001	6.084	2.188	16.912
Tumor depth	0.464	0.299	2.400	0.121	1.590	0.884	2.858
Lymphatic invasion	20.207	7720.675	0.000	0.998	5.967E8	0.000
Constant	-3.181	1.664	3.656	0.056	0.042
Male patients
Tumor size	0.594	0.707	0.705	0.401	1.810	0.453	7.233
Gross appearance	-1.420	1.442	0.969	0.325	0.242	0.014	4.085
Tumor differentiation	2.525	0.749	11.375	0.001	12.493	2.880	54.199
Tumor depth	0.838	0.359	5.448	0.020	2.313	1.144	4.676
Lymphatic invasion	20.295	8351.751	0.000	0.998	6.514E8	0.000
Constant	-5.010	2.212	5.132	0.023	0.007

Table 5 Number of retrieved lymph nodes, lymph node metastases, lymph node metastasis ratios, and incidence at each station

Node station	pN category	Number of dissected nodes			Number of metastasis nodes			Incidence of lymph node metastasis			Ratio of lymph node metastasis
Node station	pN category	T	F	M	T	F	M	T	F	M	T	F	M
No. 1	pN₁	448	111	337	100	31	69	22.30%	26.90%	20.50%	26.70%	31.40%	24.30%
No. 2	pN₁	249	67	182	54	12	42	21.70%	17.90%	23.10%	18.50%	20.00%	18.00%
No. 3	pN₁	1308	334	974	404	100	304	30.90%	29.90%	31.20%	59.60%	60.00%	59.50%
No. 4	pN₁	589	136	453	87	45	42	14.80%	33.10%	9.30%	16.40%	22.90%	14.40%
No. 5	pN₃	39	9	30	11	7	4	28.20%	77.80%	13.30%	4.10%	5.70%	3.60%
No. 6	pN₃	146	33	113	13	9	4	8.90%	27.30%	3.50%	3.40%	8.60%	1.80%
No. 7	pN₂	176	49	127	32	8	24	18.20%	16.30%	18.90%	11.60%	8.60%	12.60%
No. 8	pN₂	108	26	82	13	3	10	12.00%	11.50%	12.20%	4.10%	5.70%	3.60%
No. 9	pN₂	39	8	31	15	2	13	38.50%	25.00%	41.90%	4.10%	2.90%	4.50%
No. 10	pN₂	37	11	26	8	0	8	21.60%	0.00%	30.80%	1.40%	0.00%	1.80%
No. 11	pN₂	36	6	30	5	0	5	13.90%	0.00%	16.70%	2.70%	0.00%	3.60%
No. 12	pN₂	45	6	39	5	0	5	11.10%	0.00%	12.80%	1.40%	0.00%	1.80%
No. 13	M	8	0	8	0	0	0	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%
No. 14	M	30	2	28	0	0	0	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%
No. 15	M	13	5	8	0	0	0	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%
No. 16	M	32	0	32	6	0	6	18.80%	0.00%	18.80%	2.10%	0.00%	2.70%
No. 110	M	37	4	33	1	0	1	2.70%	0.00%	3.00%	0.70%	0.00%	0.90%
Total		3340	807	2533	754	217	537	22.70%	26.90%	21.30%

Table 6 Correlation between lymph node metastases at pN₁, pN₂ and pN₃ and clinicopathological factors

Characterists	pN₁									pN₂									pN₃
	Total			Female			Male			Total			Female			Male			Total			Female			Male
	LN+	LN-	P value	LN+	LN-	P value	LN+	LN-	P value	LN+	LN-	P value	LN+	LN-	P value	LN+	LN-	P value	LN+	LN-	P value	LN+	LN-	P value	LN+	LN-	P value
Age (yr)			0.830			0.134			0.287			0.066			0.541			0.082			0.670			0.179			0.769
< 60	33	13		5	5		28	8		11	35		2	8		9	27		4	42		0	10		4	32
≥ 60	70	30		19	6		51	24		12	88		3	22		9	66		11	89		4	21		7	68
Tumor size (cm)			0.020			0.554			0.021			0.151			0.191			0.314			0.095			0.068			0.345
< 2.0	0	2		0	0		0	2		0	2		0	0		0	2		0	2		0	0		0	2
2.0-5.0	62	31		15	8		47	23		11	82		2	21		9	61		6	87		1	22		5	65
> 5.0	41	10		9	3		32	7		12	39		3	9		9	30		9	42		3	9		6	33
Gross appearance			0.000			0.211			0.000			0.674			0.513			0.748			0.395			0.428			0.560
Type 0	0	6		0	2		0	4		0	6		0	2		0	4		0	6		0	2		0	4
Type 1	5	8		2	1		3	7		1	12		0	3		1	9		0	13		0	3		0	10
Type 2	81	24		19	7		62	17		19	86		4	22		15	64		13	92		3	23		10	69
Type 3	10	3		2	0		8	3		2	11		1	1		1	10		2	11		1	1		1	10
Type 4	7	2		1	1		6	1		1	8		0	2		1	6		0	9		0	2		0	7
Tumor differentiation			0.000			0.150			0.001			0.071			0.782			0.054			0.324			0.855			0.215
Differentiated	44	32		9	7		35	25		8	68		2	14		6	54		6	70		2	14		4	56
Undifferentiate	59	11		15	4		44	7		15	55		3	16		12	39		9	61		2	17		7	44
Pathological tumor depth			0.000			0.051			0.001			0.360			0.808			0.406			0.265			0.861			0.363
T1	1	7		0	2		1	5		0	8		0	2		0	6		0	8		0	2		0	6
T2	8	8		2	0		6	8		1	15		0	2		1	13		0	16		0	2		0	14
T3	3	1		0	1		3	0		1	3		0	1		1	2		0	4		0	1		0	3
T4	91	27		22	8		69	19		21	97		5	25		16	72		15	103		4	26		11	77
Lymphatic invasion			0.001			0.102			0.002			0.048			0.693			0.046			0.009			0.030			0.074
Yes	24	0		5	0		19	0		7	17		1	4		6	13		6	18		2	3		4	15
No	79	43		19	11		60	32		16	106		4	26		12	80		9	113		2	28		7	85
Venous invasion			0.637			0.324			0.861			0.791			0.137			0.440			0.466			0.601			0.169
Yes	4	1		2	0		2	1		1	4		1	1		0	3		1	4		0	2		1	2
No	99	42		22	11		77	31		22	119		4	29		18	90		14	127		4	29		10	98
Nerve invasion			0.792			0.856			0.679			0.734			1.000			0.669			0.001			0.111			0.001
Yes	15	7		5	2		10	5		4	18		1	6		3	12		7	15		2	5		5	10
No	88	36		19	9		69	27		19	105		4	24		15	81		8	116		2	26		6	90
Esophageal involvement			0.165			0.912			0.108			0.109			0.272			0.205			0.587			0.658			0.691
Yes	25	6		4	2		21	4		2	29		0	6		2	23		4	27		1	5		3	22
No	78	37		20	9		58	28		21	94		5	24		16	70		11	104		3	26		8	78

Table 7 Correlation between lymph node metastases at pN1, pN2 and pN3 and clinicopathological factors for sex difference

Clinicopathological factors	pN1			pN2			pN3
Clinicopathological factors	Female LN+	Male LN+	P value	Female LN+	Male LN+	P value	Female LN+	Male LN+	P value
Age (yr)			0.179			0.692			0.159
< 60	5 (15.2)	28 (84.8)		2 (18.2)	9 (81.8)		0 (0.0)	4 (100.0)
≥ 60	19 (27.1)	51 (72.9)		3 (25.0)	9 (75.0)		4 (36.4)	7 (63.6)
Tumor size (cm)			0.792			0.692			0.475
< 2.0	0 (0.0)	0 (0.0)		0 (0.0)	0 (0.0)		0 (0.0)	0 (0.0)
2.0-5.0	15 (24.2)	47 (75.8)		2 (18.2)	9 (81.8)		1 (16.7)	5 (83.3)
> 5.0	9 (22.0)	32 (78.0)		3 (25.0)	9 (75.0)		3 (33.3)	6 (66.7)
Gross appearance			0.960			0.472			0.423
Type 0	0 (0.0)	0 (0.0)		0 (0.0)	0 (0.0)		0 (0.0)	0 (0.0)
Type 1	2 (40.0)	3 (60.0)		0 (0.0)	1 (100.0)		0 (0.0)	0 (0.0)
Type 2	19 (23.5)	62 (76.5)		4 (21.1)	15 (78.9)		3 (23.1)	10 (76.9)
Type 3	2 (20.0)	8 (80.0)		1 (50.0)	1 (50.0)		1 (50.0)	1 (50.0)
Type 4	1 (14.3)	6 (85.7)		0 (0.0)	1 (100.0)		0 (0.0)	0 (0.0)
Tumor differentiate			0.555			0.782			0.634
Differentiated	9 (20.5)	35 (79.5)		2 (25.0)	6 (75.0)		2 (33.3)	4 (66.7)
Undifferentiate	15 (25.4)	44 (74.6)		3 (20.0)	12 (80.0)		2 (22.2)	7 (77.8)
Pathological tumor depth			0.624			0.738
T1	0 (0.0)	1 (100.0)		0 (0.0)	0 (0.0)		0 (0.0)	0 (0.0)	NS
T2	2 (25.0)	6 (75.0)		0 (0.0)	1 (100.0)		0 (0.0)	0 (0.0)
T3	0 (0.0)	3 (100.0)		0 (0.0)	1 (100.0)		0 (0.0)	0 (0.0)
T4	22 (24.2)	69 (75.8)		5 (23.8)	16 (76.2)		4 (26.7)	11 (73.3)
Lymphatic invasion			0.744			0.567			0.634
Positive	5 (20.8)	19 (79.2)		1 (14.3)	6 (85.7)		2 (33.3)	4 (66.7)
Negative	19 (24.1)	60 (75.9)		4 (25.0)	12 (75.0)		2 (22.2)	7 (77.8)
Venous invasion			0.198			0.052			0.533
Positive	2 (50.0)	2 (50.0)		1 (100.0)	0 (0.0)		0 (0.0)	1 (100.0)
Negative	22 (22.2)	77 (77.8)		4 (18.2)	18 (81.8)		4 (28.6)	10 (71.4)
Nerve invasion			0.247			0.862			0.733
Positive	5 (35.7)	9 (64.3)		1 (25.0)	3 (75.0)		2 (33.3)	4 (66.7)
Negative	19 (21.6)	69 (78.4)		4 (21.1)	15 (78.9)		2 (25.0)	6 (75.0)
Esophageal involvement			0.321			0.435			0.930
Presence	4 (16.0)	21 (84.0)		0 (0.0)	2 (100.0)		1 (25.0)	3 (75.0)
Absence	20 (25.6)	58 (74.4)		5 (23.8)	16 (76.2)		3 (27.3)	8 (72.7)

Citation: Ren G, Chen YW, Cai R, Zhang WJ, Wu XR, Jin YN. Lymph node metastasis in gastric cardiac adenocarcinoma in male patients. World J Gastroenterol 2013; 19(37): 6245-6257
URL: https://www.wjgnet.com/1007-9327/full/v19/i37/6245.htm
DOI: https://dx.doi.org/10.3748/wjg.v19.i37.6245