This single-center, retrospective study was conducted at the Department of Gastroenterological Surgery, University of Health Sciences Kosuyolu High Specialization Education and Research Hospital, Istanbul, Turkey. The study was carried out in accordance with the Helsinki Declaration and local laws and regulations. This study was approved by the ethical committee of Kosuyolu High Specialization Education and Research Hospital with an IRB number: 2020/14/404.
Between December 2006 and December 2019, medical records of 324 patients who underwent gastric cancer surgery were retrospectively reviewed and data of 163 eligible patients were enrolled in the study (Figure 1 ). Patients aged over 18 who underwent a curative surgery for TNM stage II or III GC were considered eligible for this study. All patients underwent open total or subtotal gastrectomy with D2 lymphadenectomy. Patients who underwent emergency surgery, had immunodeficiency or lymphoproliferative disease and had taken immunomodulatory drugs were excluded. Also, patients whose adjuvant chemotherapy was not completed were not included into the study.
Data regarding the patients' age, gender, comorbidity status, presence/absence of lymphovascular and perineural invasions (LVI and PNI), tumor histological grade, tumor size and location, total number of harvested LNs and metastatic LNs, size of the largest MLN, length of hospital stay, postoperative complications, overall survival (OS), neoadjuvant treatment status were recorded. The Clavien-Dindo classification was used to analyze postoperative complications, and grade III or higher complications were defined as major complications (11 ).
Adjuvant chemotherapy was given to all patients with a pathological stage II and III gastric cancer with LN metastases. DCF (Docetaxel, cisplatin, 5-fluorouracil) or FLOT (5-fluorouracil, leucovorin, oxaliplatin, docetaxel) regimens were given as both neoadjuvant and adjuvant chemotherapy.
The software IBM® SPSS® (Statistical Package for the Social Sciences) version 23 (IBM Corp. Armonk, NY, USA) was used for statistical analysis. Qualitative data were presented as frequency and percentage. The distribution of numerical data was performed using the Kolmogorov–Smirnov test with the non-normal distribution results. Quantitative data were given as median with Interquartile Range (IQR). The association of major complications and survival with categorical variables was analyzed using Chi-square, Fisher's exact tests, and Likelihood ratio. The Mann–Whitney-U test was used to examine whether major complications and survival were related to age, metastatic lymph node size, and length of hospital stay. The Kaplan–Meier method and the log-rank test were used to conduct the survival analyses of the metastatic lymph node size. Further, multivariate Cox regression analyses were performed to examine role of the metastatic lymph node size in predicting mortality. A p-value of less than 0.05 was defined as statistically significant.
Between December 2006 and December 2019, medical records of 324 patients who underwent gastric cancer surgery were retrospectively reviewed and data of 163 eligible patients were enrolled in the study (
Data regarding the patients' age, gender, comorbidity status, presence/absence of lymphovascular and perineural invasions (LVI and PNI), tumor histological grade, tumor size and location, total number of harvested LNs and metastatic LNs, size of the largest MLN, length of hospital stay, postoperative complications, overall survival (OS), neoadjuvant treatment status were recorded. The Clavien-Dindo classification was used to analyze postoperative complications, and grade III or higher complications were defined as major complications (11 ).
Adjuvant chemotherapy was given to all patients with a pathological stage II and III gastric cancer with LN metastases. DCF (Docetaxel, cisplatin, 5-fluorouracil) or FLOT (5-fluorouracil, leucovorin, oxaliplatin, docetaxel) regimens were given as both neoadjuvant and adjuvant chemotherapy.
The software IBM® SPSS® (Statistical Package for the Social Sciences) version 23 (IBM Corp. Armonk, NY, USA) was used for statistical analysis. Qualitative data were presented as frequency and percentage. The distribution of numerical data was performed using the Kolmogorov–Smirnov test with the non-normal distribution results. Quantitative data were given as median with Interquartile Range (IQR). The association of major complications and survival with categorical variables was analyzed using Chi-square, Fisher's exact tests, and Likelihood ratio. The Mann–Whitney-U test was used to examine whether major complications and survival were related to age, metastatic lymph node size, and length of hospital stay. The Kaplan–Meier method and the log-rank test were used to conduct the survival analyses of the metastatic lymph node size. Further, multivariate Cox regression analyses were performed to examine role of the metastatic lymph node size in predicting mortality. A p-value of less than 0.05 was defined as statistically significant.
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