title: Long-term outcomes after D2 gastrectomy for early gastric cancer: survival analysis of a single-center experience in China.
abstract: BACKGROUND
  Early gastric cancer (EGC) is well accepted as having a favorable prognosis, but some patients experience an ominous outcome after curative resection. This study was aimed at evaluating predictive factors associated with prognosis of D2 gastrectomies in patients with early gastric cancer.
  
  
  METHODS
  A total of 518 patients with early gastric cancer who underwent D2 gastrectomies were reviewed in this study. The clinicopathological features and surgical outcomes were analyzed. The survival rate was estimated using the Kaplan-Meier method and compared by log rank test. Prognostic factors were analyzed using a multivariate Cox proportional hazards model.
  
  
  RESULTS
  The 5-year survival rate was 90.3%. Tumor infiltration, lymph node metastasis and lymphovascular invasion were significant prognostic factors for survival. Gender, age, tumor size, tumor location, macroscopic type and histological type were not significant prognostic factors. Multivariate analysis indicated that lymph node metastasis was an independent poor prognosis factor.
  
  
  CONCLUSIONS
  Early gastric cancers with lymph node metastasis have a relatively poor prognosis after standard surgery. Even after curative resection, patients with EGC with positive lymph nodes should be closely followed and be considered as candidates for comprehensive therapies.
authors.affiliation: Department of Abdominal Surgical Oncology, Cancer Hospital of the Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China E-mail : zhouzx2014@gmail.com.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Wang
authors.forename: Li
authors.initials: L
authors.lastname: Ma
authors.forename: Xing-Mao
authors.initials: XM
authors.lastname: Zhang
authors.forename: Zhi-Xiang
authors.initials: ZX
authors.lastname: Zhou
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D002288:Adenocarcinoma, Mucinous / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018279:Carcinoma, Signet Ring Cell / Q000473:pathology / Q000601:surgery; D002681:China; D018572:Disease-Free Survival; D061345:Early Medical Intervention; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D008137:Longitudinal Studies; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult