Negative Lymph Node Is an Independent Prognostic Factor for Stage III Gastric Cancer Patients After Curative Gastrectomy: A Surveillance, Epidemiology, and End Results-Based Study

Background Negative lymph node (NLN)' s prognostic impact on stage III gastric cancer (GC) patients after curative gastrectomy has not been rigorously studied. We aimed to explore the relationship between NLNs count and outcomes of stage III GC patients. Methods We retrospectively investigated stage III gastric cancer cases between 2008 and 2018 from Surveillance, Epidemiology, and End Results (SEER) database. Variables were compared by chi2 test. Kaplan-Meier methods and COX proportional hazard models were used to ascertain independent prognostic factors. Survival differences among the subgroups were analyzed to assess the effects of NLN count on overall survival (OS) in stage III GC patients. Results 2373 patients with curative gastrectomy for stage III GC were identified. Univariate analysis demonstrated that NLNs count>14 was associated better 5-year OS (43.7% VS 23.1%, P< .001) comparing with the NLNs count <= 14. Subgroup analysis showed that the NLNs count could predict survival in both node-negative and node-positive patients. Multivariate analysis revealed NLNs count is an independent prognostic factor. Conclusions The NLNs count is an independent prognostic factor for survival in stage III gastric cancer patients after curative gastrectomy and should be recommended for clinical applications.