title: Prognostic significance of a new system for categorization of the number of lymph node metastases in gastric cancer.
abstract: OBJECTIVE
  We examined whether a new system for categorization of the number or level of lymph node metastases would improve survival prediction in patients with gastric cancer.
  
  
  METHODS
  Node-positive gastric cancer patients (361) were retrospectively studied. Cox proportional-hazards model analysis of the numbers of metastatic lymph nodes (numbers 1 to 11) showed the first peak of the hazard ratio for death at a threshold value of 4 lymph node metastases. We calculated cumulative 5-year survival rates and examined prognostic factors by multivariate analysis according to the numbers and levels of lymph node metastases. The effects of other prognostic factors were also examined.
  
  
  RESULTS
  We divided the number of lymph node metastases into two groups (1-3 vs. > or =4), and classified the level of lymph node metastasis as level I or level II as defined by the Japanese Classification of Gastric Carcinoma. The 5-year survival rate differed significantly according to the number of lymph node metastases (1-3 vs. > or = 4) (p<0.0001). On multivariate regression analysis, the level of lymph node metastasis (level I or level II) and the number of lymph node metastases (1-3 or > or = 4) were independent predictors of survival.
  
  
  CONCLUSIONS
  Categorization of the number of metastatic lymph nodes (1-3 or > or = 4) was easy and provided an accurate predictor of survival in patients with gastric cancer.
authors.affiliation: Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Tomoya
authors.initials: T
authors.lastname: Funada
authors.forename: Mitugu
authors.initials: M
authors.lastname: Kochi
authors.forename: Shintaro
authors.initials: S
authors.lastname: Yamazaki
authors.forename: Masashi
authors.initials: M
authors.lastname: Fujii
authors.forename: Tadatoshi
authors.initials: T
authors.lastname: Takayama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology*; D015996:Survival Rate