Tumor Volume As An Indicator Of Nodal Status In Advanced Gastric Carcinoma

Background: The significance of tumor volume as an indicator of lymph node metastasis in advanced gastric cancer remains to be clarified. Materials and Methods: Tumor volume was measured from continuous tissue sections taken from 60 patients with advanced gastric cancer (34 males and 26 females; aged 35 to 81 years; average 57.3 years) using a computer generated surface rendering method. The tumor volume and conventional clinicopathological factors were then analyzed with respect to the prevalence of lymph node metastasis. Results: Lymph node metastasis was detected in 26 patients (43%). Of 28 patients with a tumor greater than or equal to 2000mm(3), lymph node metastasis was observed in 17 patients (61%): n1, 12 patients; n2, 3 patients; n3, 2 patients. Of 32 patients with a tumor < 2000mm(3) lymph node metastasis was observed in 9 patients (28%): n1, 6 patients; n2, 3 patients. A significant difference was found in the prevalence of lymph node metastasis between the two groups (p=0.011). Furthermore, only tumor volume was an independent variable associated with lymph node metastasis according to logistic regression analysis (p=0.013, odds ratio: 0.253, 95% confidence interval: 0.086-0.747). Conclusion: Tumor volume appears to be an important indicator of lymph node metastasis in advanced gastric cancer. However, this factor cannot be used to introduce the option of limited lymphadenectomy for such patients.