title: Impact of lymph node micrometastasis on gastric carcinoma prognosis: a meta-analysis.
abstract: OBJECTIVE
  To investigate the prognostic significance of lymph node micrometastasis (LNMM) in patients with gastric carcinoma.
  
  
  METHODS
  Two reviewers independently searched electronic databases including PubMed, EMBASE, the Cochrane Database of Systematic Reviews, the Cochrane Controlled Studies Register, and the China National Knowledge Infrastructure electronic database between January 1996 and January 2014. Strict literature retrieval and data extraction were performed to extract relevant data. Data analysis was conducted using RevMan 5.2.4 software, and relative risks (RRs) for patient death in five years and recurrence were calculated. A fixed- or random-effects model was selected to pool and a forest plot was used to display RRs.
  
  
  RESULTS
  Twelve cohort studies containing a total of 1684 patients were identified. LNMM positivity was worse than LNMM negativity with regards to the number of patients who died in five years. The effects of LNMM positivity in patients with gastric cancer of different T-stages remain unclear. LNMM in patients with gastric carcinoma was also associated with a higher recurrence rate. With regards to the number of patients who died in five years, Asian patients were worse than European and Australian patients.
  
  
  CONCLUSIONS
  We recommend that LNMM should not be used as a gold standard for prognosis evaluation in patients with gastric cancer in clinical settings until more high quality trials are available.
authors: Yong-Ji Zeng, Chun-Dong Zhang, Dong-Qiu Dai, Department of Gastrointestinal Surgery, the Fourth Affiliated Hospital of China Medical University, Shenyang 110032, Liaoning Province, China.
authors: Yong-Ji
authors: YJ
authors: Zeng
authors: Yong-Ji Zeng, Chun-Dong Zhang, Dong-Qiu Dai, Department of Gastrointestinal Surgery, the Fourth Affiliated Hospital of China Medical University, Shenyang 110032, Liaoning Province, China.
authors: Chun-Dong
authors: CD
authors: Zhang
authors: Yong-Ji Zeng, Chun-Dong Zhang, Dong-Qiu Dai, Department of Gastrointestinal Surgery, the Fourth Affiliated Hospital of China Medical University, Shenyang 110032, Liaoning Province, China.
authors: Dong-Qiu
authors: DQ
authors: Dai
mesh_terms: D002277:Carcinoma / Q000208:ethnology / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D016009:Chi-Square Distribution; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D061206:Neoplasm Micrometastasis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000208:ethnology / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome
keywords: Gastric carcinoma; Lymph node micrometastasis; Meta-analysis; Survival