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Revista Colombiana de Cirugía
Print version ISSN 2011-7582On-line version ISSN 2619-6107
Abstract
GARCIA, Ana María and SANCHEZ, William. Undifferentiated adenocarcinoma as a predictor of lymph node metastases in gastric cancer. rev. colomb. cir. [online]. 2021, vol.36, n.4, pp.620-625. Epub Feb 16, 2022. ISSN 2011-7582. https://doi.org/10.30944/20117582.860.
Introduction.
The degree of cellular differentiation in the histopathological study of gastric adenocarcinoma is described as a determining prognostic factor in the clinical behavior of the tumor. Undifferentiated gastric adenocarcinoma is considered an aggressive variant with a poor prognosis, which is correlated with a high rate of lymph node metastasis.
Methods.
Descriptive prospective study of a series of cases in which patients with undifferentiated gastric adenocarcinoma who underwent radical surgery with DII gastrectomy and lymphadenectomy and their correlation with the presence of lymph node metastases in a period of two years.
Results.
From January 2018 to January 2020, 113 patients with gastric adenocarcinoma were collected in the database who underwent total gastrectomy, DII lymph node dissection and end-to-side esophagojejunal reconstruction with the Orr plus Roux-en-Y technique. Forty-one patients (36.3%) were histologically classified as undifferentiated gastric adenocarcinoma. The average age of this group was 56 years with a range between 28-92 years. Of these, 30 were men (73%) and 11 women (27%). The mean number of lymph nodes analyzed per specimen was 24. Of the 41 patients with undifferentiated gastric adenocarcinoma, 35 (85%) had lymph node metastases, with 382 positive nodes in total, with a range between 1-38 and a mean of 11 positive lymph nodes per specimen.
Discussion.
In this series, undifferentiated gastric adenocarcinoma occurred in 36.3% of cases and was correlated with 85% of the presence of lymph node metastases in T3-T4.
Keywords : gastric cancer; adenocarcinoma; cell differentiation; lymph node metastases; prognosis.