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Impact of microsatellite status on negative lymph node count and prognostic relevance after curative gastrectomy
Author(s) -
Cai Zhenghao,
Ma Junjun,
Li Shuchun,
Fingerhut Abe,
Sun Jing,
Zang Lu,
Yan Chao,
Liu Wentao,
Zhu Zhenggang,
Zheng Minhua
Publication year - 2021
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.26325
Subject(s) - medicine , lymph node , microsatellite instability , lymphadenectomy , lymph , pathological , odds ratio , gastroenterology , oncology , pathology , microsatellite , biology , gene , allele , biochemistry
Background and Objectives The impact of microsatellite instability‐high (MSI‐H) phenotype on lymph node yield after lymphadenectomy has never been discussed in gastric cancer (GC). In this study, we aimed to assess the association of microsatellite status with negative lymph node count (NLNC) as well as its prognostic value. Methods We retrospectively analyzed 1491 GC patients and divided them into two groups: MSI‐H GC ( n = 141 [9.5%]) and microsatellite stability (MSS GC ) ( n = 1350 [90.5%]). The NLNC and survival data were compared between the two groups. The log odds of positive lymph nodes (LNs) to negative LNs and the target lymph node examined threshold (TLNT) were calculated in both groups. Results A statistically significant difference was found in median NLNC (26 vs. 23, p < .001) between MSI‐H GC and MSS GC patients. MSI status was an independent factor for NLNC ( p < .001). NLNC showed positive prognostic value for cases with metastatic lymph node (LN + ) in both MSI‐H GC and MSS GC groups. The TLNT (90%) for MSI‐H GC and MSS GC were 33 and 26, respectively. Conclusions MSI‐H GC was associated with higher NLNC in GC patients and this was independent of the presence of LN + . However, more LNs are needed during pathological examination to capture LN + cases in MSI‐H GC.