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

Abstract

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.

A retrospective study on intensity-modulated radiation therapy combined with chemotherapy after D2 radical surgery for gastric carcinoma

“…Other studies demonstrated that the prognosis of the patients was associated with the absolute number of positive lymph nodes when the lymph node sampling was sufficient (16 required by TNM, AJCC 7th edition); however, the metastatic lymph node ratio and log odds of positive lymph nodes may be used to better assess prognosis when lymph node sampling was inadequate (31,32). In addition to the status of lymph node metastasis, the factors affecting the prognosis of gastric cancer also included TNM stage, depth of tumor infiltration, vascular invasion and nerve invasion (33,34). Histological classification (34) and tumor size (35,36) may also be used to predict the prognosis of patients with advanced gastric carcinoma.…”

Conventional clinical and pathological features fail to accurately predict recurrence in patients with gastric cancer staged N0

“…Identification of the factors associated with survival and recurrence of LN-negative GC patients following curative resection is important to choose appropriate candidates for sequentially essential adjuvant therapy [10]. Although several investigators have reported that the postoperative prognosis of LN-negative GC patients was significantly better than that of LN-positive GC patients, some researchers found that a minority of LN-negative GC patients developed recurrence and poor survival.…”

Risk of recurrence after laparoscopy-assisted radical gastrectomy for gastric cancer performed by a single surgeon

“…In addition, Lai et al reported that male gender, elevated gross type, and presence of lymph node metastasis are related to early recurrence of EGC [30]. Deng et al reported that limited lymphadenectomy, few dissected nodes, and serosal involvement are related to postoperative recurrence in lymph-node-negative gastric cancer patients [31]. The results of the present study are consistent with those of previous studies, since high TNM stage was found to be an independent factor for tumor recurrence.…”