The prognostic analysis of lymph node-positive gastric cancer patients following curative resection

J Surg Res. 2010 Jun 1;161(1):47-53. doi: 10.1016/j.jss.2008.12.019. Epub 2009 Jan 10.

Abstract

Background: The purpose of this study was to evaluate the appropriate prognostic indicators of lymph node-positive gastric cancer patients following curative resection.

Methods: A retrospective study of 196 lymph node-positive patients who underwent radical gastrectomy (R0) for gastric cancer from January 1997 to December 2000 was analyzed statistically to identify the intensive indictors of prognosis.

Results: In 196 evaluable patients, 5-year survival rate was 33.2%. A total of 4048 lymph nodes were examined (median, 20.6; range, 15-49), and 1661 lymph nodes were positive (median, 8.5; range, 1-37). The median survival was 29 months. With multivariate analysis, we found number and ratio of metastatic lymph nodes were associated with overall survival (OS) of lymph node-positive patients after curative surgery. However, we ultimately identified that ratio of metastatic lymph nodes was more appropriate to evaluate OS of lymph node-positive patients than number of metastatic lymph nodes by using the case-control matched fashion. One hundred forty-four (73.5%) patients had recurrence after curative surgery. The median disease-free time was 18 month, and the median survival after recurrence was 4 month. With multivariate analysis (logistic regression model), we found number of metastatic lymph nodes was associated with recurrence after curative surgery.

Conclusion: Ratio and number of metastatic lymph nodes were important indicators of OS and recurrence of lymph node-positive gastric cancer patients following curative resection, respectively.

MeSH terms

  • Adult
  • Aged
  • Carcinoma / diagnosis*
  • Carcinoma / mortality
  • Carcinoma / surgery
  • China / epidemiology
  • Female
  • Humans
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / epidemiology*
  • Prognosis
  • Retrospective Studies
  • Stomach Neoplasms / diagnosis*
  • Stomach Neoplasms / mortality
  • Stomach Neoplasms / surgery
  • Survival Analysis
  • Young Adult