Prognostic factors in patients with node-negative gastric carcinoma: a comparison with node-positive gastric carcinoma.
OBJECTIVE
To identify the clinicopathological characteristics of lymph node-negative gastric carcinoma, and also to evaluate outcome indicators in the lymph node-negative patients.


METHODS
Of 2848 gastric carcinoma patients, 1524 (53.5%) were lymph node-negative. A statistical analysis was performed using the Cox model to estimate outcome indicators.


RESULTS
There was a significant difference in the recurrence rate between lymph node-negative and lymph node-positive patients (14.4% vs 41.0%, P<0.001). The 5-year survival rate was significantly lower in lymph node-positive than in lymph node-negative patients (31.1% vs 77.4%, P<0.001). Univariate analysis revealed that the following factors influenced the 5-year survival rate: patient age, tumor size, depth of invasion, tumor location, operative type, and tumor stage at initial diagnosis. The Cox proportional hazard regression model revealed that tumor size, serosal invasion, and curability were independent, statistically significant, prognostic indicators of lymph node-negative gastric carcinoma.


CONCLUSIONS
Lymph node-negative patients have a favorable outcome attributable to high curability, but the patients with relatively large tumors and serosal invasion have a poor prognosis. Curability is one of the most reliable predictors of long-term survival for lymph node-negative gastric carcinoma patients.
Division of Gastroenterologic Surgery, Department of Surgery, Chonnam National University Medical School, Gwangju, Korea. dockim@jnu.ac.kr
Dong Yi
DY
Kim
Kyeung Won
KW
Seo
Jae Kyoon
JK
Joo
Young Kyu
YK
Park
Seong Yeob
SY
Ryu
Hyeong Rok
HR
Kim
Young Jin
YJ
Kim
Shin Kon
SK
Kim
D000368:Aged; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis / Q000175:diagnosis* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000473:pathology; D009367:Neoplasm Staging; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D016016:Proportional Hazards Models; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate