The survival of stage III gastric cancer patients is affected by the number of lymph nodes removed.
BACKGROUND
Lymph node (LN) removal has been an important component in surgical treatment of gastric cancer. However, it is not clear whether the number of lymph nodes resected affects patient survival.


METHODS
We retrospectively reviewed the records of 147 patients with adenocarcinoma of the stomach who had undergone gastrectomy with curative intent between 1992 and 2001. Patients were divided into two groups: group I patients had < or =15 (n=124) and group II patients had >15 (n=23) LN reported.


RESULTS
The two groups were similar in age, gender distribution, and tumor locations. Group II patients had more advanced tumor, node, and overall staging. The median survival was 23.0 and 31.8 months for groups I and II, respectively. In stage III patients, median survival was 14.4 months for group I and 33.8 months for group II (P=.006). Group II patients also had more proximal lesions (P<.001) and a decreased positive to removed LN ratio (P=.014).


CONCLUSIONS
For stage III disease, removal of >15 LN appears to contribute to a considerable survival advantage. Because extended lymphadenectomy will most reliably allow >15 LN removed and add no operative morbidity and mortality, we strongly recommend it be considered in curative resections of gastric cancer.
Liu
Katherine J M
KJ
Rush Medical College and Stroger Hospital of Cook County, 1901 W. Harrison, Chicago, IL 60612, USA.
Loewen
Mark
M
Atten
Mary Jo
MJ
Millikan
Keith
K
Tebbit
Christopher
C
Walter
Robert J
RJ
D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D000368:Aged; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D016019:Survival Analysis