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J Surg Oncol. 2006 Sep 15;94(4):275-80; discussion 274.

Number of lymph node metastases and its prognostic significance in early gastric cancer: a multicenter Italian study.

Author information

1
Dipartimento di Chirurgia Generale ed Oncologica, Università di Siena, Siena, Italia. roviello@unisi.it

Abstract

BACKGROUND AND OBJECTIVES:

This study was aimed at evaluating the prognostic significance of the number of metastatic nodes in early gastric cancer (EGC).

METHODS:

In this multicenter retrospective study 652 cases of resected EGC were analyzed. We searched for lymph node metastases-associated risk factors and to identify subsets of patients with different prognosis according to the number of involved nodes.

RESULTS:

Nodal involvement was observed in 14.1%. A significant correlation was found between the presence of node metastases and tumor size (RR 1.34, P = 0.001), submucosal invasion (RR: 3.14, P = 0.007), Lauren diffuse/mixed type (RR: 4.88, P < 0.001) and Kodama Pen A type (RR: 4.59, P < 0.001). The 10-year survival rate was 92% for N0 cases, 82% and 73% for tumors with one to three and four to six positive nodes while it dropped to 27% with more than six metastatic nodes. Interestingly enough, the 10-year risk of recurrence diminished with the increasing number of retrieved nodes (>15) even in N0 patients.

CONCLUSIONS:

Nodal involvement confirmed to be a significant prognostic factor. In view of the trend to a lower risk of recurrence when more than 15 nodes were retrieved and the better staging achieved we consider D2 lymphadenectomy the treatment of choice.

PMID:
16917863
DOI:
10.1002/jso.20566
[Indexed for MEDLINE]

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