Exploration of the Radiotherapeutic Clinical Target Volume Delineation for Gastric Cancer from Lymph Node Metastases

Aim: To clarify the clinical target volume of regional lymph nodes (CTVn) delineation of gastric adenocarcinoma. Materials and Methods: The pattern of lymph node metastases (LNM) of a total of 1,473 patients with gastric cancer (GC) who had undergone gastrectomy and lymphadenectomy with more than 15 lymph nodes retrieved was retrospectively examined. Results: A univariate analysis showed that T stage (p<0.001), macroscopic type (p=0.001), tumor differentiation (p<0.001), maximum diameter of tumor (p<0.001) as well as cancer embolus (p<0.001) were closely associated with the rate of LNM. While by multivariate analysis, gender [odds ratio (OR=0.687, p<0.05], maximum diameter (OR=1.734, p<0.001), tumor differentiation (OR=1.584, p<0.001), T stage (OR=2.066, p<0.001) and cancer embolus (OR=4.912, p<0.001) were strongly associated with the rate of LNM. Conclusion: In conclusion, for male patients with GC with large, deeply invasive, poorly differentiated, diffusely infiltration and positive cancer embolus, the radiation fields should be enlarged appropriately.

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