Risk of station 12a lymph node metastasis in patients with lower-third gastric cancer

Table 1 Clinicopathological characteristics of patients with station 12a lymph node dissection

Characteristic	n	Station 12a lymph nodes		χ2	P value
		Negative (n = 129)	Positive (n = 18)
Gender				0.061	0.806
Male	91	82	9
Female	56	47	9
Age at surgery, yr				0.242	0.622
< 60	84	74	10
≥ 60	63	55	8
Lauren classification				5.911	0.052
Intestinal	78	69	9
Diffuse	68	60	8
Mixed	1	0	1
Borrmann type				1.165	0.761
I	7	6	1
II	52	47	5
III	81	71	10
IV	7	5	2
Maximum diameter				4.491	0.034
4 cm or less	77	73	4
More than 4 cm	70	56	14
Examined lymph node count				1.241	0.538
< 16	47	42	5
16-30	69	61	8
> 30	31	26	5
pT stage				10.112	0.039
T1	2	2	0
T2	28	28	0
T3	10	9	1
T4a	102	86	16
T4b	5	4	1
pN stage				61.092	< 0.001
N0	56	56	0
N1	22	22	0
N2	36	32	4
N3a	19	10	9
N3b	14	9	5
Soft tissue invasion				19.249	< 0.001
Yes	31	23	8
No	115	105	10
Perineuronal invasion				0.719	0.397
Yes	1	1	0
No	146	128	18
Vessel invasion				0.279	0.597
Yes	2	2	0
No	145	127	18
Adjuvant chemotherapy				5.997	0.014
Yes	97	82	15
No	50	47	3
Blood transfusion				1.394	0.238
Yes	19	17	2
No	128	112	16

Table 2 Univariate and multivariate analyses of predictive factors for station 12a lymph nodes metastasis

Variables	Univariate analysis			Multivariate analysis1			Multivariate analysis2
	OR	95%CI	P value	OR	95%CI	P value	OR	95%CI	P value
Gender	1.745	0.648-4.700	0.271
Age at surgery	1.076	0.399-2.906	0.885
Lauren classification	1.427	0.549-3.709	0.465
Borrmann type	1.404	0.643-3.066	0.396
Maximum diameter	4.562	1.424-14.619	0.011	2.838	0.743-10.840	0.127	4.012	1.231-13.078	0.021
Examined lymph node count	1.268	0.641-2.510	0.495
pT stage	2.935	1.807-7.924	0.034	1.456	0.389-5.449	0.577	2.055	0.749-5.642	0.162
pN stage	3.336	1.971-5.648	< 0.001	3.322	1.962-5.625	< 0.001
Soft tissue invasion	3.500	1.249-9.804	0.017	1.201	0.350-4.121	0.771	2.912	1.007-8.420	0.048
Perineuronal invasion	0.000	0.000	1.000
Vessel invasion	0.000	0.000	0.999
Surgical options	0.568	0.240-1.343	0.197
BMI	1.400	0.519-3.779	0.507
Adjuvant chemotherapy	2.866	0.789-10.415	0.11
Blood transfusion	0.824	0.174-3.903	0.807

¹Four factors with significance (P < 0.05) in the univariate analysis were included in the multivariate analysis.

²Factors with significance in univariate analysis excluding pN stage were included in the multivariate analysis.

CI: Confidence interval; OR: Odds ratio; BMI: Body mass index.

Table 3 Multivariate analysis of risk factors for survival of patients with lower-third gastric cancer

Variable	Cox regression analysis1		Cox regression analysis2
	95%CI	P value	95%CI	P value
Station 12a lymph node metastasis	0.775-2.576	0.260	1.659-5.043	< 0.001
Maximum diameter	0.690-1.559	0.859	0.722-1.644	0.682
pT stage	0.852-1.439	0.446	0.926-1.524	0.175
pN stage	1.291-1.809	< 0.001
Soft tissue invasion	1.189-3.063	0.007	1.334-3.386	0.002
Adjuvant chemotherapy	0.841-2.028	0.234	0.823-1.969	0.279

¹Five factors with significance (P < 0.05) in the univariate analysis of survival were included in the multivariate analysis.

²Four factors with significance excluding pN stage.

CI: Confidence interval.

Table 4 Survival analysis of clinicopathological characteristics based on status of station 12a lymph nodes

Variable	No. 12a (+)		No. 12a (-)
	5-YSR (%)	P value	5-YSR (%)	P value
Maximum diameter		0.408		0.142
4 cm or less	0		45.2
More than 4 cm	7.1		32.1
pT stage		0.152		0.158
T1	-		100.0
T2	-		60.7
T3	0		55.6
T4a	6.3		31.4
T4b	0		0
pN stage		0.619		< 0.001
N0	-		60.7
N1	-		31.8
N2	0		31.3
N3a	11.1		20.0
N3b	0		0
Soft tissue invasion		0.003		0.002
+	0		12.5
-	10		45.7
No. 1 LNs		0.873		0.292
+	0		28.6
-	7.7		40.2
No. 2 LNs		0.171		0.407
+	33.3		20.0
-	0		40.3
No. 3 LNs		0.950		< 0.001
+	7.7		12.5
-	0		48.5
No. 4sb LNs		0.408		0.042
+	14.3		0
-	0		42.1
No. 6 LNs		0.290		< 0.001
+	0		10.8
-	14.3		51.1
No. 7 LNs		0.143		0.028
+	0		23.1
-	10		43.7
No. 8a LNs		0.173		< 0.001
+	0		6.3
-	8.3		44.2

5-YSR: Five-year survival rate; LN: Lymph node.

Table 5 Association between status of other regional lymph nodes and station 12a lymph node metastasis

Variables	No. 12a metastasis	Univariate analysis			Multivariate analysis
		OR	95%CI	P value	OR	95%CI	P value
No. 1 LNs
+	5	6.703	1.860-24.163	0.004
-	13
No. 2 LNs
+	3	4.960	1.076-22.868	0.040
-	15
No. 3 LNs
+	13	7.881	2.608-23.821	< 0.001	7.881	2.608-23.821	< 0.001
-	5
No. 4sa LNs
+	3	3.025	0.723-12.657	0.130
-	15
No. 4sb LNs
+	7	4.836	1.626-14.383	0.005
-	11
No. 4d LNs
+	0	0.000	0.000	0.999
-	18
No .5 LNs
+	4	3.065	0.860-10.929	0.084
-	14
No. 6 LNs
+	11	3.907	1.407-10.853	0.009
-	7
No. 7 LNs
+	8	3.169	1.138-8.828	0.027
-	10
No. 8a LNs
+	6	3.531	1.163-10.726	0.026
-	12
No. 8p LNs
+	0	0.000	0.000	0.999
-	18
No. 9 LNs
+	2	1.115	0.230-5.403	0.892
-	16
No. 10 LNs
+	0	0.000	0.000	0.999
-	18
No. 11p LNs
+	1	3.735	0.321-43.427	0.292
-	17
No. 11d LNs
+	0	0.000	0.000	1.000
-	18

CI: Confidence interval; OR: Odds ratio; LN: Lymph node.

Table 6 Possibility of regional lymph node predictors of station 12a lymph node invasion

Possible predictor	Sensitivity	Specificity	False negative	False positive	P value	Kappa value
No. 1	27.8	94.6	72.2	5.4	0.263	0.261
No. 2	16.7	96.1	83.3	3.9	0.041	0.168
No. 3	72.2	75.2	27.8	24.8	0.000	0.288
No. 4d	0.0	97.7	100.0	2.3	1.000	-0.036
No. 4sa	16.7	93.8	83.3	6.2	0.2101	0.126
No. 4sb	38.9	88.4	61.1	11.6	0.557	0.249
No. 5	22.2	91.5	77.8	8.5	0.148	0.690
No. 6	61.1	72.1	38.9	27.9	0.000	0.196
No. 7	44.4	79.8	55.6	20.2	0.011	0.176
No. 8a	33.3	87.6	66.7	12.4	0.191	0.572
No. 8p	0.0	97.7	100.0	2.3	1.0001	-0.036
No. 9	11.1	89.9	88.9	10.1	0.011	0.711
No. 10	0.0	98.4	100.0	1.6	1.0001	-0.025
No. 11d	0.0	99.2	100.0	0.8	1.0001	-0.013
No. 11p	5.6	98.4	94.4	1.6	0.001	0.062

¹Fisher test.