ĐẶC ĐIỂM DI CĂN HẠCH CỦA BỆNH NHÂN UNG THƯ BIỂU MÔ TUYẾN DẠ DÀY ĐƯỢC PHẪU THUẬT NỘI SOI TẠI BỆNH VIỆN K

Abstract

Background: Lymph node metastasis is a major prognostic factor in gastric adenocarcinoma, directly influencing treatment strategies and patient survival. In Vietnam, evidence regarding nodal metastasis patterns in patients undergoing laparoscopic gastrectomy remains limited. Methods: A retrospective descriptive study was conducted on 155 patients with gastric adenocarcinoma who underwent laparoscopic gastrectomy at K Hospital from January 2020 to June 2025. Clinicopathological characteristics and lymph node metastasis were analyzed to identify associated predictive factors. Data were processed using SPSS 20.0, with statistical significance set at p < 0.05. Results: The mean number of retrieved lymph nodes was 17.3 ± 6.2. The overall rate of lymph node metastasis was 19.4%. Nodal metastasis significantly increased with tumor invasion depth, from 1.9% in pT1 to 70.0% in pT4 (p < 0.001). Poor differentiation (33.3% vs. 17.1% and 0%; p = 0.02) and lymphovascular/perineural invasion (50.0% vs. 16.3%; p = 0.002) were strongly associated with a higher risk of nodal metastasis. Conclusions: Tumor invasion depth, histological differentiation, and  lymphovascular/perineural invasion are important prognostic indicators for lymph node metastasis in gastric adenocarcinoma managed via laparoscopic gastrectomy. Patients with high-risk features require appropriate strategies including extended lymphadenectomy, adjuvant therapy, and close postoperative surveillance.