Journal
EJSO
Volume 39, Issue 11, Pages 1287-1293Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.ejso.2013.07.183
Keywords
Gastric cancer; Number of examined lymph node; Lymphadenectomy; Node-negative; Prognostic factor
Funding
- Chang Gung Medical Research Program, Taiwan [CMRPG 380161]
- Department of Health, Taiwan [DOH99-TD-C-111-006, PMRPG390071]
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Aim: In this study, we investigated the prognostic significance of the number of examined lymph nodes in node-negative gastric adenocarcinoma (GC). Patients and methods: A total of 1194 node-positive and 1030 node-negative GC patients undergoing potentially curative gastrectomy was enrolled in this study. Patients were stratified into 3 groups according to the number of examined lymph nodes: group 1, <= 15; group 2, 16-25; group 3, >25. Results: Patients with node-negative GC had significantly favorable survival compared with those with node-positive. Among patients with node-negative T2-T4 disease, the percentage of locoregional relapse was higher in those with <25 examined lymph nodes than in those with >= 25 examined lymph nodes. The number of examined lymph nodes affected the overall survival rates for patients with node-negative T2-T4 GC but not for patients with T1 lesions. Tumor size, tumor location, the number of examined lymph nodes, T status, and the presence of perineural invasion were significant prognostic factors as determined by multivariate analysis in node-negative GC. Conclusions: No survival benefit of examining >= 15 lymph nodes was noted for patients with node-negative T1 GC. Extensive lymphadenectomy in patients with node-negative T2-T4 lesions in whom the number of examined lymph nodes was >25 had favorable survival. Crown Copyright (C) 2013 Published by Elsevier Ltd. All rights reserved.
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