Prognostic indicators in node-negative advanced gastric cancer patients.
OBJECTIVE
Despite carrying better overall prognoses, some node-negative gastric cancer patients die from recurrent malignancies. Identifying factors associated with disease-specific survival in adequately staged node-negative gastric cancer is important, as these patients are presumably free of microscopic regional metastases and may derive significant benefit from existing or future adjuvant strategies.


METHODS
To investigate significant prognostic indicators in node-negative advanced gastric cancer patients, we reviewed 777 advanced gastric cancer patients who had undergone curative gastrectomies.


RESULTS
The 5-year survival rate of node-negative advanced gastric cancer patients is 84.9%, which is significantly better than that of patients with lymph node metastasis. Multivariate analysis indicated that tumor size, histology, and depth of invasion are independent prognostic factors. The 5-year survival rate of patients with larger tumors (>or=7 cm), poorly differentiated adenocarcinoma, and serosal invasion was 49.1%, which was significantly worse that of patients with fewer or none of these factors.


CONCLUSIONS
Tumor size, histology, and the presence of serosal invasion are strong indicators of poor prognosis in node-negative advanced gastric cancer patients.
Saito
Hiroaki
H
Division of Surgical Oncology, Department of Surgery, Tottori University School of Medicine, Yonago, Japan. sai10@med.tottori-u.ac.jp
Kuroda
Hirohiko
H
Matsunaga
Tomoyuki
T
Fukuda
Kenji
K
Tatebe
Shigeru
S
Tsujitani
Shunichi
S
Ikeguchi
Masahide
M
D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery; D016019:Survival Analysis