Prognostic value of the number of metastatic lymph nodes in gastric cancer with radical surgery

Abstract

To evaluate the effectiveness of extended lymph node dissection in gastric cancer, the relationship between the number of lymph nodes with metastasis and the long-term outcome was studied retrospectively in 761 patients who underwent curative resection with extensive lymph node dissection. The cumulative 5-year survival rate was 85.8% in patients without lymph node metastasis, 60.2% in those with 1-4 lymph nodes, 35.6% with 5-10 nodes, and 12.3% with 11 or more nodes involved. Concerning N2 or N3 patients in whom metastatic lymph nodes would have remained without extensive dissection, the 5-year survival rate was 70.5% in those with 1-4 lymph nodes involved and 44.0% with 5 or more lymph nodes involved when no serosal invasion was observed. It was 38.5% with 1-4 lymph nodes and 5% with 5 or more lymph nodes involved when serosal invasion was observed. These results suggest that extensive lymph node dissection is effective in gastric cancer patients without serosal invasion and, when only a few lymph nodes are involved, also in those with serosal invasion. However, it is not considered to be effective in patients with serosal invasion and metastasis to many lymph nodes. Combination therapies are thought to be required in such patients.

Clinicopathologic characteristics and prognostic factors in 10 783 patients with gastric cancer

“…Therefore we performed a quantitative analysis to determine the status of lymph node metastasis as a prognostic factor in gastric cancer. Previously, we had suggested that the staging of lymph node metastasis should be based on the number of involved lymph nodes [26], and several reports agreed with our suggestion [39][40][41]. The UICC TNM classification revised in 1997 [42] ultimately adopted the number of involved lymph nodes as a parameter for the assessment of lymph node metastatic status, although the cat-egories were rather different from ours.…”

Prognostic factors in patients with advanced gastric cancer with macroscopic invasion to adjacent organs treated with radical surgery

“…Lymph node metastasis was reported to be one of the important prognostic factors in patients with gastric cancer [10][11][12]. In patients with T4 gastric cancer, as well as patients with early gastric cancer [13] and those with T3 advanced gastric cancer [14], lymph node metastasis was an important prognostic factor.…”

Gastric cancer with extragastric lymph node metastasis: multivariate prognostic study

“…Table 4 lists the 5-year survival rates of patients with gastric cancer with extragastric lymph node metastasis and shows that the level of lymph node metastasis is associated with survival [22][23][24][25][26][27][28][29][30][31]. The 5-year survival rates of n2 and n3 cases in our series were in accordance with those in the literature, and the 5-year survival rate was significantly different between the n2 and n3 cases in most series, including ours (39% vs 17%; P Ͻ 0.05).…”