Frequency of lymph node involvement in patients with gastric cancer in Ramsar Imam Sajjad hospital from 2010-2015

Gastric cancer is one of the most prevalent cancers of digestion system. Despite a decrease in incidence in recent decades, gastric cancer is still one of the most common causes of death worldwide. Many prognostic factors identified to affect the survival rate include age, depth of tumor invasion to gastric wall, grade, tumor diameter and regional lymph node involvement. In areas without screening for gastric cancer, diagnosis are late and have a high frequency of nodal involvement. It is important to evaluate LN status preoperatively for proper treatment strategy.
We reviewed 90 patients with gastric cancer who had gastrectomy over a 5-year period (2010-2015) using a retrospective study design.
Our study showed a high incidence of lymph node involvement in patients (73%) and most of them had N3 involvement. The study consisted of 65% male with ratio of 1.94:1 and ranged from 23-83 (mean age 63). Most patients were at grade III, stage IV, and most tumors had above 4cm in diameter and invasion to subserosa (T4). The most frequent clinical sign was epigastric pain, followed by loss of appetite and weight. The correlation between the lymph node status and other parameters showed that the maximum risk for nodal metastasis depend on tumor diameter and depth of invasion.
In this study high incidence of LN metastasis shows that gastric cancer diagnoses late in advanced stages because of lack of screening methods and knowledge about disease. Due to high frequency of disease in this area, it is necessary to have screening methods for earlier diagnose and increase the rate of 5-year survival.