title: Large lymph node size harvested as prognostic factor in gastric cancer?
abstract: OBJECTIVE
  Knowledge regarding prognostic factors in gastric cancer is essential to decide on single patient management. We aim to establish the value of large lymph node size in order to improve perioperative approach.
  
  
  METHODS
  Charts of one hundred and twenty-eight consecutive patients undergoing gastrectomy for resectable gastric cancer were reviewed between January 1996 and December 2005. Patients were split in two groups according to large lymph node size harvested, group I, lymph node size <or= 10 mm and group II, lymph node size > 10 mm. Overall five-year survival related to cancer were analyzed as a main endpoint. Prognostic factors as TNM classification and degree of differentiation have been considered.
  
  
  RESULTS
  There were no differences regarding age and gender (67.4 vs. 64; p = 0.34 and 66,1 vs. 68,1%; p = 0.27, respectively). Nevertheless, a significant difference has been found according to T1-T2 of TNM stage (78.1 vs. 39.1% p = < 0.001), for N grade staging, has statistical signification for grade N0 (62.7 vs. 30.5%; p < 0.001), and for Ia and Ib stages (57.6 vs. 17.4%). Five years overall survival has a great statistical signification (p log-rank = 0.0003), however, overall survival between groups with positive lymph nodes according to lymph node size was close to signification, (p log-rank = 0.0636).
  
  
  CONCLUSIONS
  Our data indicates that large lymph node size could be a powerful predictor for overall survival in gastric cancer, when it could be evaluated in preoperative period. In our opinion lymph node size should be considered for perioperative chemotherapy schemas. Detection and staging techniques for lymph node affection acquire much more importance.
authors.affiliation: General Surgery Department, Universidad Autònoma de Barcelona, Barcelona, Spain. fran-espin@hotmail.com
authors.forename: Francisco
authors.initials: F
authors.lastname: Espín
authors.forename: A
authors.initials: A
authors.lastname: Bianchi
authors.forename: S
authors.initials: S
authors.lastname: Llorca
authors.forename: L
authors.initials: L
authors.lastname: Pulido
authors.forename: J
authors.initials: J
authors.lastname: Felíu
authors.forename: J
authors.initials: J
authors.lastname: de-la-Cruz
authors.forename: E
authors.initials: E
authors.lastname: Palomera
authors.forename: O
authors.initials: O
authors.lastname: García
authors.forename: J
authors.initials: J
authors.lastname: Remon
authors.forename: X
authors.initials: X
authors.lastname: Suñol
mesh_terms: D000368:Aged; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D016019:Survival Analysis