Most Important Lymph Node Information in Gastric Cancer: Multivariate Prognostic Study

Adachi, Yosuke; Shiraishi, Norio; Suematsu, Toshihiro; Shiromizu, Akio; Yamaguchi, Kensei; Kitano, Seigo

doi:10.1007/s10434-000-0503-1

Cited by 44 publications

(30 citation statements)

References 24 publications

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“…32,33 Lymphatic involvement is one of the most important prognostic factors in gastric cancer. 12,34 The prognostic value of LR in the evaluation of lymph node status found in this study confirms the results from previous studies. 1,35,36 The extent of lymph node dissection to optimize the benefit to the patient is still controversial.…”

Section: Discussionsupporting

confidence: 91%

“…Nevertheless, for gastric cancer, as well as for other cancers, the prognostic value of these factors has been consistently recognized. 1,4,12,34,42,43 Neglecting them may lead to important problems in the interpretation of scientific results, including the difficulty of inferring therapeutic results for each patient individually, in addition to a morphological staging group, and the impossibility of ascribing different survival rates to the treatment, because clinical factors are not taken into account. 44 Several alternative models designed to improve the accuracy of prognostic estimates of gastric cancer patients are published in the medical literature.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prognostic Score in Gastric Cancer: The Importance of a Conjoint Analysis of Clinical, Pathologic, and Therapeutic Factors

et al. 2006

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Background: This study was designed to establish a prognostic score for gastric cancer that takes into account factors related to the tumor, the patient, and the treatment.Methods: Two hundred thirty patients with gastric adenocarcinoma admitted to the Department of Abdominal Surgery at Hospital do Caˆncer A. C. Camargo (Sa˜o Paulo) and treated by gastrectomy from January 1992 until December 1996 were included in this retrospective cohort. The prognostic score was created according to the variables identified in the multivariate analysis and by using the regression coefficients generated by the Cox regression.Results: The 5-year overall survival rate was 44.5%. The final multivariate model identified six variables with a significant and independent effect on survival: sex, weight loss, lymphocyte count, tumor-node-metastasis staging, lymphadenectomy, and lymph node ratio. Patients were divided into four groups according to their scores, as follows: group 1, 0 to 3.0; group 2, 3.5 to 5.5; group 3, 6.0 to 8.5; and group 4, 9.0 to 14.0. The 5-year survival rates were 91.5%, 49.3%, 20.3%, and .0% for the score groups 1, 2, 3, and 4, respectively (P < .001). The score was superior in the assessment of prognosis when compared with tumor-node-metastasis staging alone.Conclusions: It is possible to create a prognostic score that simultaneously includes factors related to the tumor, patient, and treatment, thus generating a more effective system in predicting the prognosis than the morphology-based staging systems.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Prognostic Score in Gastric Cancer: The Importance of a Conjoint Analysis of Clinical, Pathologic, and Therapeutic Factors

et al. 2006

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“…In the present study, we found that D2 lymphadenectomy did not contribute to extending OS, but did contribute to extending disease-free survival of lymph node-negative gastric cancer patients. Many studies demonstrated that the number of dissected lymph nodes was not relative to the prognosis of gastric cancer patients after curative surgery (46)(47)(48). Our results revealed that the number of dissected lymph nodes did not affect OS but did affect disease-free survival.…”

Section: Discussionmentioning

confidence: 99%

Prognosis of Gastric Cancer Patients with Node-Negative Metastasis following Curative Resection: Outcomes of the Survival and Recurrence

Deng

Liang

Sun

et al. 2008

Canadian Journal of Gastroenterology

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of gastric cancer patients with node-negative metastasis following curative resection: Outcomes of the survival and recurrence. Can J Gastroenterol 2008;22(10):835-839.BACKGROUND: The purpose of the present study was to provide valuable prognostic information on lymph node-negative gastric cancer patients following curative resection. METHODS: Data from 112 lymph node-negative gastric cancer patients who underwent curative resection were reviewed to identify the independent factors of overall survival and recurrence. RESULTS: The five-year survival rate of lymph node-negative gastric cancer patients was 85.7%, and recurrence was identified in 25 patients after curative surgery. The five-year survival rate of lymph node-negative gastric cancer patients was higher than that of lymph node-positive gastric cancer patients (P<0.001). Recurrence in lymph node-negative gastric cancer patients was less than that of lymph node-positive gastric cancer patients (P=0.001). The median survival after recurrence of lymph node-negative gastric cancer patients was longer than that of lymph node-positive gastric cancer patients (P=0.021). Using multivariate analyses, the following results were determined for lymph node-negative gastric cancer patients: sex, operative type and the presence of serosal involvement were independent factors of overall survival; and lymphadenectomy, number of dissected nodes and the presence of serosal involvement were independent factors of recurrence. CONCLUSIONS: The prognosis of lymph node-negative gastric cancer patients was better than that of lymph node-positive gastric cancer patients. Male sex, subtotal gastrectomy and nonserosal involvement should be considered to be the favourable predictors of postoperative long-term survival of lymph node-negative gastric cancer patients. Conversely, limited lymphadenectomy, few dissected nodes and serosal involvement should be considered to be risk factors of postoperative recurrence of lymph node-negative gastric cancer patients.

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“…The status of LN metastasis is one of the most important prognostic indicators after surgery [2,3,4,5]. However, the extent of LN dissection required during gastric surgery to achieve the optimal result remains controversial [6,7,8].…”

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics of Gastric Cancer with Metastasis to the Lymph Node along the Superior Mesenteric Vein (14v)

et al. 2008

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Aim: We investigated the clinical significance of metastasis to the lymph node (LN) along the superior mesenteric vein (14v) in gastric cancer. Methods: A retrospective study of 2,513 gastrectomy patients with a 14v dissection was done using the Ganken Igan Database. Results: The incidence of 14v metastasis correlated with tumor location, depth of tumor invasion, regional LN metastases, peritoneal metastasis, peritoneal cytology-positive, hepatic metastasis and postoperative recurrence (p < 0.01). Metastases to the infrapyloric LN (6), suprapyloric LN (5) and left paracardial LN (2) were independent variables affecting 14v metastasis (p < 0.05), and the 6 status was a useful predictive factor for a 14v-negative status with a low false-negative rate (1.9%). The patients with 14v metastasis after curative surgery demonstrated a significantly lower survival rate than those without (5-year overall survival rate; 11.3 vs. 60.2%, p < 0.0001). In them, LN around the abdominal aorta (16)-positive group showed a significantly lower survival rate than the negative group (p < 0.05). Conclusions: Advanced gastric cancer with invasion to the lower stomach often metastasizes to 14v, and the 6 status can predict 14v negative. Most patients with 14v metastasis have a poor prognosis, similar to those with systemic metastasis, although some such patients may benefit from a curative dissection.

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Most Important Lymph Node Information in Gastric Cancer: Multivariate Prognostic Study

Cited by 44 publications

References 24 publications

Prognostic Score in Gastric Cancer: The Importance of a Conjoint Analysis of Clinical, Pathologic, and Therapeutic Factors

Prognostic Score in Gastric Cancer: The Importance of a Conjoint Analysis of Clinical, Pathologic, and Therapeutic Factors

Prognosis of Gastric Cancer Patients with Node-Negative Metastasis following Curative Resection: Outcomes of the Survival and Recurrence

Clinical Characteristics of Gastric Cancer with Metastasis to the Lymph Node along the Superior Mesenteric Vein (14v)

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