Retrospective Analysis of Diagnosis and Treatment of Gastric Cancer at Huzhou Central Hospital

Objective . To explore the results of lymph node metastasis in patients with gastric cancer in a real-world setting. Methods . Patients (n = 272) who underwent radical gastrectomy with lymph node dissection for gastric cancer from November 2017 to August 2019 at Huzhou Central Hospital, China. The main outcome was the lymph node metastasis rate. The chi-square test was used to compare categorical variables. Binary logistic regression analysis was used to examine the relationship between risk factors and lymph node metastasis in gastric cancer and early gastric cancer. In multivariate analysis, OR and 95% CI were calculated to evaluate the risk. Statistical significance was defined as P < .05. Statistical analysis was performed using SPSS software version 26.0 (SPSS Inc.) and GraphPad PRISM 9.0. Results . Among the 272 patients who underwent surgery, 143 (52.6%) had lymph node metastasis. The proportion of female patients was higher in those under 40 years of age. The incidence of gastric cancer was highest in the lesser curvature of the gastric antrum. The lymph node metastasis rates were 5.3%, 25%, 39%, 78.1%, and 76.8% for invasion to the mucosal layer, submucosal layer, muscular layer, serosal layer, and beyond the serosal layer, respectively. There was a statistically significant difference in lymph node metastasis between invasion to the mucosal layer and the other four layers (P < .05), while there was no statistically significant difference between invasion to the submucosal and muscular layers (P >.05) and between invasion to the serosal layer and beyond (P >.05). Well-differentiated gastric cancer had almost no lymph node metastasis (0%), while moderately differentiated gastric cancer had a lower rate of lymph node metastasis (32%), and there was no statistically significant difference between the two. The lymph node metastasis rates were higher for poorly differentiated adenocarcinoma (66.7%), mucinous adenocarcinoma (63.6%), and signet ring cell carcinoma (57.1%), and there was no statistically significant difference between the three. Conclusion . Lymph node metastasis in gastric cancer is related to the depth of invasion and pathological subtype, and is not related to age, sex, or tumor location.