title: Clinicopathologic characteristics and outcome indicators in node-negative gastric cancer.
abstract: OBJECTIVE
  The relationship between the number of lymph nodes examined and the outcome in patients with node-negative (N(-)) gastric cancer was studied. We compared N(-) patients to those with nodal involvement (N(+)) to identify clinicopathologic characteristics of N(-) gastric cancer. Finally, we evaluated outcome indicators in this group of patients.
  
  
  METHODS
  Of 367 patients, 130 (35.4%) were N(-). These patients were stratified according to the main prognostic variables, to assess differences with N(+) cases. A statistical analysis using the Cox model was performed to estimate outcome indicators.
  
  
  RESULTS
  N(-) gastric carcinomas were significantly different from N(+) cases in terms of tumor depth and site, TNM stage, grading, residual disease, and vessel involvement. The overall 5-year survival rate was 72%. It was 82% in those patients with more than 15 nodes retrieved and 59% in the others. Serosal involvement, residual disease, and poor differentiation were independent prognostic factors.
  
  
  CONCLUSIONS
  The clinicopathologic factors and outcome of N(-) cases were similar to those of early gastric cancer. At least 15 examined nodes appears to be necessary to define a case as N(-). The prognostic value of D2 lymphadenectomy in N(-) patients suggests a biologic role of micrometastases.
authors.affiliation: Institute of General Surgery, University of Florence, Italy. clin_chir_dc@unifi.it
authors.forename: L
authors.initials: L
authors.lastname: Bruno
authors.forename: G
authors.initials: G
authors.lastname: Nesi
authors.forename: F
authors.initials: F
authors.lastname: Montinaro
authors.forename: G
authors.initials: G
authors.lastname: Carassale
authors.forename: V
authors.initials: V
authors.lastname: Boddi
authors.forename: P
authors.initials: P
authors.lastname: Bechi
authors.forename: C
authors.initials: C
authors.lastname: Cortesini
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate