Abstract:

Objective To investigate the clinicopathological characteristics and survival analysis of patients with gastric cancer with left supraclavicular lymph node metastasis. Methods The gastric cancer database entered from 2010 to 2019 in the Department of Surgery of the Third Hospital of Hebei Medical University from 2010 to 2019 was retrieved，and the ultrasound ⁃guided puncture pathology to confirm the left supraclavicular lymph node metastasis was screened out. The clinical pathological characteristics，survival and related prognostic factors were analyzed. Results A total of 286 cases of gastric cancer with left supraclavicular lymph node metastasis were retrieved，accounting for 2.62% of the total number of gastric cancer patients admitted during the same period. Among them，there were 157 males（54.90%）and 129 females（45.10%），and the median age was 59 years old. 79 cases（27.62%）were located in the cardia，69 cases（24.13%）in the gastric body，and 91 cases（31.82%）in the antrum，47 cases（16.43%）of whole stomach；192 cases（67.13%）with lesions ≥ 5 cm，94 cases（32.87%） with lesions less than 5 cm；103 cases（36.01%）with Borrmann classification of type Ⅰ to Ⅱ，and type Ⅲ to Ⅳ 183 cases（63.99%）；65 cases（22.73%）of high⁃medium differentiated adenocarcinoma，and 221 cases（77.27%） of low⁃undifferentiated adenocarcinoma. Of the 286 patients with gastric cancer with supraclavicular lymph node metastasis，277（96.85%）were followed up，with a 2⁃year overall survival（OS）of 51.26% and a 2⁃year progres⁃ sion⁃free survival（PFS）of 42.24%. COX multivariate analysis showed that the tumor tissue type was poorly differ⁃entiated⁃undifferentiated type（HR = 2.164，95%CI：1.085～8.316，P = 0.028），and the depth of invasion was cT4a～cT4b stage（P = 0.005），tumor marker CEA（P = 0.007），combined with positive abdominal exfoliation cytology and peritoneal metastasis（P = 0.001）is an independent risk factor affecting the prognosis of gastric cancer patients with left supraclavicular lymph node metastasis，and they received conversion therapy（including systemic chemotherapy or systemic chemotherapy + HIPEC chemotherapy）（P = 0.001）and R0 surgery treatment is a pro⁃ tective factor affecting the prognosis（P = 0.001）. Conclusion The prognosis of gastric cancer patients with left supraclavicular lymph node metastasis is poor，which is closely related to a variety of clinical factors，and active conversion therapy could improve the prognosis.

Key words: gastric cancer,  , left supraclavicular lymph node metastasis,  , clinical features,  , prognosis