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

Franco Roviello, Simone Rossi, Daniele Marrelli, Corrado Pedrazzani, Giovanni Corso, Carla Vindigni, Paolo Morgagni, Luca Saragoni, Giovanni De Manzoni, Anna Tomezzoli

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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 NO 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 NO 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.

Original languageEnglish
Pages (from-to)275-280
Number of pages6
JournalJournal of Surgical Oncology
Volume94
Issue number4
DOIs
Publication statusPublished - Sep 15 2006

Keywords

  • Early gastric cancer
  • Lymph node dissection
  • Lymph node metastases
  • Surgical treatment

ASJC Scopus subject areas

  • Surgery
  • Oncology

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    Roviello, F., Rossi, S., Marrelli, D., Pedrazzani, C., Corso, G., Vindigni, C., Morgagni, P., Saragoni, L., De Manzoni, G., & Tomezzoli, A. (2006). Number of lymph node metastases and its prognostic significance in early gastric cancer: A multicenter Italian study. Journal of Surgical Oncology, 94(4), 275-280. https://doi.org/10.1002/jso.20566