Sex-specific differences in risk factors of lymph node metastasis in patients with early gastric cancer

Autoři: Eun Sook Ryu aff001;  Seung Jun Chang aff002;  Jungsuk An aff003;  Jun-Young Yang aff004;  Jun-Won Chung aff002;  Yoon Jae Kim aff002;  Kyoung Oh Kim aff002;  Dong Kyun Park aff002;  Kwang An Kwon aff002;  Seungyoon Nam aff001;  Woon Kee Lee aff006;  Jung Ho Kim aff002
Působiště autorů: College of Medicine, Gachon University, Incheon, Republic of Korea aff001;  Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon, Republic of Korea aff002;  Department of Pathology, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon, Republic of Korea aff003;  Department of Life Sciences, Gachon Advanced Institute of Health Sciences & Technology, Gachon University, Incheon, Republic of Korea aff004;  Gachon Institute of Genome Medicine and Science, Gachon University Gil Medical Center, Incheon, Republic of Korea aff005;  Department of Surgery, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon, Republic of Korea aff006;  Gachon Medical Research Institute, Gachon University Gil Medical Center, Incheon, Republic of Korea aff007
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224019


Accurate prediction of lymph node status is of crucial importance in the appropriate treatment planning for patients with early gastric cancer (EGC). Some studies have examined factors predicting lymph node metastasis (LNM) in EGC; however, these studies did not consider sex-specific differences. This study aimed to investigate sex-specific differences in predictive risk factors of LNM in EGC based on surgical specimens. Patients who underwent surgical treatment for EGC between January 2003 and February 2016 were retrospectively evaluated. Patients who underwent previous gastric surgery or treatment for gastric neoplasms were excluded. Finally, 1076 patients treated for EGC were included in the analysis. We analyzed risk factors of LNM by dividing patients into male and female groups. Of 1076 patients (mean age 59.6 years), 69% were men. The overall LNM rate was 9.4%. The LNM rate was lower in men (7.8%) than in women (12.9%). Multivariate analysis showed that elevated type (odds ratio [OR], 2.084; 95% confidence interval [CI]: 1.053–4.125; P = 0.035), submucosal invasion (OR, 2.162; 95% CI: 1.018–4.595; P = 0.045), undifferentiated type (OR, 2.044; 95% CI: 1.107–3.772; P = 0.022), and lymphovascular invasion (LVI) (OR, 7.210; 95% CI: 3.835–13.554; P<0.001) were independent predictive risk factors of LNM in EGC in men. However, only submucosal invasion (OR, 8.772; 95% CI: 2.823–27.259; P<0.001) and LVI (OR, 8.877; 95% CI: 3.861–20.410; P<0.001) were independent predictive risk factors of LNM in EGC in women. Submucosal invasion and LVI were risk factors of LNM in both men and women. However, elevated and undifferentiated types were risk factors in men but not in women. Clinicians should consider these sex-specific differences with regard to individualized management.

Klíčová slova:

Cancer risk factors – Gastric cancer – Histology – Lymph nodes – Metastasis – Multivariate analysis – Surgical and invasive medical procedures – Surgical oncology


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Článek vyšel v časopise


2019 Číslo 10