The Prognostic Analysis of Lymph Node-Positive Gastric Cancer Patients Following Curative Resection

Background. The purpose of this study was to evaluate the appropriate prognostic indicators of lymph node-positive gastric cancer patients following curative resection. Methods. A retrospective study of 196 lymph node-positive patients who underwent radical gastrectomy (R0) for gastric cancer from January 1997 to December 2000 was analyzed statistically to identify the intensive indictors of prognosis. Results. In 196 evaluable patients, 5-year survival rate was 33.2%. A total of 4048 lymph nodes were examined (median, 20.6; range, 15-49), and 1661 lymph nodes were positive (median, 8.5; range, 1-37). The median survival was 29 months. With multivariate analysis, we found number and ratio of metastatic lymph nodes were associated with overall survival (OS) of lymph node-positive patients after curative surgery. However, we ultimately identified that ratio of metastatic lymph nodes was more appropriate to evaluate OS of lymph node-positive patients than number of metastatic lymph nodes by using the case-control matched fashion. One hundred forty-four (73.5%) patients had recurrence after curative surgery. The median disease-free time was 18 month, and the median survival after recurrence was 4 month. With multivariate analysis (logistic regression model), we found number of metastatic lymph nodes was associated with recurrence after curative surgery. Conclusion. Ratio and number of metastatic lymph nodes were important indicators of OS and recurrence of lymph node-positive gastric cancer patients following curative resection, respectively. (C) 2010 Elsevier Inc. All rights reserved.