Effect of lymph node dissection on the prognosis in patients with node-negative early gastric cancer.
BACKGROUND
Our objective was to evaluate the long-term benefit of R2/3 lymph node dissection compared with that of R1, even in node-negative cases.


METHODS
We analyzed clinicopathologic data on 373 surgically treated patients with early gastric cancer and without microscopic nodal involvement.


RESULTS
Five- and 10-year survival rates for patients treated with R2/3 gastrectomy were 97.3% and 95.4%, respectively. These values were significantly higher than the 90.1% and 81.1% noted for R1 gastrectomy (p < 0.01). Although no difference was found in morbidity and mortality, the incidence of death from a recurrence of the gastric cancer was significantly higher in patients treated with R1 gastrectomy than those with R2/3. Multivariate analysis with the Cox's proportional hazard model revealed patients' age and R2/3 gastrectomy to be independent prognostic factors in patients with node-negative early gastric cancer.


CONCLUSIONS
These data show that prophylactic lymph node dissection can potentially prolong the survival time of patients with node-negative early gastric cancer by preventing a recurrence of the gastric cancer.
Department of Surgery II, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
H
H
Baba
Y
Y
Maehara
H
H
Takeuchi
S
S
Inutsuka
T
T
Okuyama
Y
Y
Adachi
K
K
Akazawa
K
K
Sugimachi
D000367:Age Factors; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D013997:Time Factors