title: A multicentric Western analysis of prognostic factors in advanced, node-negative gastric cancer patients.
abstract: BACKGROUND
  The presence of lymph node metastasis is one of the most important prognostic factors in patients with gastric carcinoma. Node-negative patients have a better outcome, nevertheless a subgroup of them experience disease recurrence.
  
  
  OBJECTIVE
  To analyze the clinicopathological characteristics of lymph node-negative advanced gastric carcinoma patients submitted to gastrectomy and D2 lymphadenectomy with a retrieved number of nodes greater than 15, after an actual follow-up of almost 5 years, and to evaluate outcome indicators.
  
  
  METHODS
  The records of 301 patients who underwent curative gastrectomy for gastric carcinoma and were adequately staged as N0 between 1992 and 2002 were retrospectively analyzed from the prospectively collected database of 7 centers participating to the Italian Research Group for Gastric Cancer.
  
  
  RESULTS
  Disease-specific and disease-free survival after 3, 5, and 10 years were 90.4%, 86.1%, 75.9%, and 72.1%, 57.3%, 57.3%, respectively. Mortality was 1.7%. The factors associated with a better disease-free survival at univariate analysis were age <60, T2 tumors, distal location, intestinal histotype, and number of retrieved nodes >25; depth of infiltration and histotype were the only 2 independent predictors of 5-year recurrence-free survival at multivariate analysis.
  
  
  CONCLUSIONS
  These parameters must be considered to stratify node-negative gastric cancer patients for an adjuvant treatment and follow-up scheduling. Survival was similar to that previously reported by Eastern Centers. Lymphadenectomy is suggested to be effective, and retrieval of more than 25 nodes may be warranted.
authors.affiliation: Department of Medical and Surgical Sciences, Surgical Clinic, Brescia University, Brescia, Italy. baiocchi@med.unibs.it
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: Baiocchi
authors.forename: Guido A
authors.initials: GA
authors.lastname: Tiberio
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Minicozzi
authors.forename: Paolo
authors.initials: P
authors.lastname: Morgagni
authors.forename: Daniele
authors.initials: D
authors.lastname: Marrelli
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Bruno
authors.forename: Fausto
authors.initials: F
authors.lastname: Rosa
authors.forename: Alberto
authors.initials: A
authors.lastname: Marchet
authors.forename: Arianna
authors.initials: A
authors.lastname: Coniglio
authors.forename: Luca
authors.initials: L
authors.lastname: Saragoni
authors.forename: Marco
authors.initials: M
authors.lastname: Veltri
authors.forename: Fabio
authors.initials: F
authors.lastname: Pacelli
authors.forename: Franco
authors.initials: F
authors.lastname: Roviello
authors.forename: Donato
authors.initials: D
authors.lastname: Nitti
authors.forename: Stefano M
authors.initials: SM
authors.lastname: Giulini
authors.forename: Giovanni
authors.initials: G
authors.lastname: De Manzoni
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology