[Impact of dissected lymph node number on the prognosis of advanced cancer of cardiac and stomach fundus].
OBJECTIVE
To investigate the impact of dissected lymph node number on the prognosis of patients with advanced cancer of cardia and stomach fundus.


METHODS
Clinical data of 236 patients with advanced cancer of cardia and stomach fundus undergone D(2) radical resection were reviewed retrospectively. Five-year survival rate and post-operative complication rate were followed up and their relationships with dissected lymph node number were analyzed respectively.


RESULTS
The 5-year survival rate of the entire cohort was 37.5%. Among those patients with the same stage, the more lymph nodes (LNs) resected, the better survival outcomes achieved(Log-rank trend test P=0.0013). A cut point analysis yielded the ability to detect the significant survival differences. The best long-term survival outcomes were observed with LN counts of more than 20 for stage II(P=0.0136), more than 25 for stage III(P<0.0001), more than 30 for stage IV(P=0.0002) or more than 15 for the entire cohort (P=0.0024), with greatest comparative discrepancies. The post-operative complication rate was 15.7% and was not significantly correlated with dissected lymph node number(P=0.101).


CONCLUSIONS
The prognosis of patients with advanced cancer of cardia and stomach fundus is associated with the number of resected LNs when D(2) lymphadenectomy is carried out. Suitable increment of dissected lymph node number would not increase the post-operative complication rate.
Lin
Bi-Juan
BJ
Department of Oncology, The Affiliated Union Hospital, Fujian Medical University, Fuzhou 350001, China.
Huang
Chang-Ming
CM
Lu
Hui-Shan
HS
Zhang
Xiang-Fu
XF
Li
Ping
P
Xie
Jian-Wei
JW
D000328:Adult; D000368:Aged; D002299:Cardia / Q000473:pathology; D005260:Female; D005748:Gastric Fundus / Q000473:pathology; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery