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Risk assessment of lymph node metastasis in early gastric cancer patients with vagus nerve-preserving gastrectomy: A multiple centers potential analysis in China

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机构: [1]Tianjin Med Univ, Natl Clin Res Ctr Canc, Tianjins Clin Res Ctr Canc, Dept Gastr Surg,Canc Inst & Hosp,Tianjin Key Lab D, Tianjin 300060, Peoples R China [2]Fujian Med Univ, Fujian Prov Hosp, Shengli Clin Med Coll, Dept Gastrointestinal Surg, Fuzhou, Fujian, Peoples R China [3]Harbin Med Univ, Canc Hosp, Dept Gastroenterol Surg, Harbin, Heilongjiang, Peoples R China [4]Sichuan Univ, West China Hosp, Dept Gen Surg, Chengdu, Sichuan, Peoples R China [5]Sichuan Univ, West China Hosp, Collaborat Innovat Ctr Biotherapy, Lab Gastr Canc, Chengdu, Sichuan, Peoples R China [6]Sichuan Univ, West China Hosp, Canc Ctr, Chengdu, Sichuan, Peoples R China [7]Anyang Tumor Hosp, Dept Gastr Surg, Anyang, Henan, Peoples R China [8]Sun Yat Sen Univ, Affiliated Hosp 6, Dept Gastrointestinal Surg, Dept Gen Surg, Guangzhou, Guangdong, Peoples R China [9]North Sichuan Med Coll, Dept Gastrointestinal Surg 2, Affiliated Hosp, Nanchong, Sichuan, Peoples R China [10]Southern Med Univ, Guangdong Prov Peoples Hosp, Dept Gastrointestinal Surg, Dept Gen Surg, Guangzhou, Guangdong, Peoples R China [11]Fujian Med Univ, Shanghai Canc Ctr, Fujian Canc Hosp, Dept Gastr Surg Oncol,Clin Oncol Sch,Fujian Branch, Fuzhou, Fujian, Peoples R China [12]Chinese Acad Med Sci & Peking Union Med Coll, Natl Canc Ctr, Natl Clin Res Ctr Canc, Dept Pancreat & Gastr Surg,Canc Hosp, Beijing, Peoples R China [13]Dalian Univ Technol, Liaoning Canc Hosp & Inst, Dept Gastr Canc, Canc Hosp, Shenyang, Liaoning, Peoples R China
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Background: Vagus nerve-preserving gastrectomy is gaining popularity for early gastric cancer treatment. This study assesses vagus nerve-preserving gastrectomy's perioperative safety and impact on postoperative quality of life, and explores vagus nerve-associated lymph node metastasis to create a risk model for enhanced therapy. Methods: Clinicopathologic data from 1,210 early gastric cancer patients across 11 Chinese centers were analyzed, and the data of 800 patients with follow-up information and 48 patients who underwent vagus nerve-preserving gastrectomy for validation were collected. Propensity score matching was applied to the analysis of perioperative safety and quality of life in vagus nerve-preserving gastrectomy patients. A 6-point risk assessment model was devised and validated to evaluate the risk of vagus nerve-associated lymph node metastasis after vagus nerve-preserving gastrectomy in early gastric cancer patients. Results: Vagus nerve-preserving gastrectomy patients had shorter postoperative stays, quicker drainage cessation, and fewer incidences of diarrhea, acid reflux, and postoperative gallstones. Additionally, key independent risk factors for vagus nerve-associated lymph node metastasis included tumor size, differentiation type, invasion depth, and lymphatic vessel invasion. Using these factors, a 6-point risk assessment model was established. The values of the area under the receiver operating characteristic curve for the model were 0.796, 0.806, 0.808, and 0.829 in the training cohort, internal validation cohort, external validation cohort, and vagus nerve-preserving gastrectomy cohort, respectively. The model effectively differentiated between high-and low-risk groups in terms of postoperative survival.

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大类 | 2 区 医学
小类 | 2 区 外科
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大类 | 2 区 医学
小类 | 2 区 外科
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Q1 SURGERY
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Q1 SURGERY

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第一作者机构: [1]Tianjin Med Univ, Natl Clin Res Ctr Canc, Tianjins Clin Res Ctr Canc, Dept Gastr Surg,Canc Inst & Hosp,Tianjin Key Lab D, Tianjin 300060, Peoples R China
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