Preoperatively predicting the lymph node metastasis and prognosis for gastric cancer patients

Abstract

The preoperative distinguishment of lymph nodes (LN) with metastasis plays a pivotal role in guiding the surgical extension for gastric cancer (GC). We aim to identify the preparative risk factors for LN metastasis in GC patients. We retrospectively reviewed 424 patients who underwent radical GC resection in our medical center between Jan 2011 and Dec 2018. Multivariate logistic regression was employed to identify risk factors for LN metastasis, while multivariate COX regression was utilized to evaluate prognostic factors. 245 out of 424 people were identified with LN metastases. In multivariate analysis, low levels of albumin and prealbumin, as well as high levels of CEA, CA199, and platelets, were found to be significantly associated with LN metastasis in patients with GC. In survival analysis, older age, larger tumors, higher levels of D-dimer and CA199, advanced staging, lower prealbumin levels, and absence of adjuvant chemotherapy was discovered to be associated with a poorer prognosis in patients with GC. In conclusion, our results demonstrated that preoperative prealbumin-bound tumor markers can effectively predict LN metastasis in GC. Additionally, prealbumin was found to possess prognostic value as well.