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.
Number of lymph node metastases and its prognostic significance in early gastric cancer: a multicenter Italian study / F. Roviello, S. Rossi, D. Marrelli, C. Pedrazzani, G. Corso, C. Vindigni, P. Morgagni, G. De Manzoni, L. Saragoni, A. Tomezzoli. - In: JOURNAL OF SURGICAL ONCOLOGY. - ISSN 0022-4790. - 94:4(2006), pp. 275-280.
Number of lymph node metastases and its prognostic significance in early gastric cancer: a multicenter Italian study
G. Corso;
2006
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.File | Dimensione | Formato | |
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