title: Survival after Gastrectomy in Node-Negative Gastric Cancer: A Review and Meta-Analysis of Prognostic Factors.
abstract: BACKGROUND
  Lymph node metastasis is one of the most important prognostic factors for survival of patients with gastric cancer (GC) after surgical resection. Nevertheless, a considerable number of patients have node-negative disease. We performed the present systematic review to evaluate survival and identify prognostic factors in node-negative GC patients undergoing curative intent resection.
  
  
  METHODS
  Relevant studies published between January 2000 and January 2015 were identified by searching the PubMed database and reviewed systematically. Summary relative risks (RR) and 95% confidence intervals (95% CI) were estimated using random-effects models.
  
  
  RESULTS
  Thirty observational studies involving 12 504 patients were included in the review. Median 5-year overall survival was 84.3% (range, 53-96.3%). Pooled analysis showed that old age (RR, 1.26; 95%CI, 1.13-1.42), <D2 lymph node dissection (1.28; 1.05-1.55), larger tumor (1.18; 1.10-1.26), serosal invasion (2.03; 1.68-2.44), lymphatic invasion (1.25; 1.00-1.57), vascular invasion (1.67; 1.19-2.34), and lymphovascular invasion (1.93; 1.20-3.10) were significant association with decreased survival.
  
  
  CONCLUSIONS
  Surgical resection offers good overall survival for patients with node-negative GC. Tumor-related factors seem to have most prognostic significance.
authors.affiliation: Department of Hepato-Biliary-Pancreato-Vascular Surgery, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China (mainland).
authors.forename: Yanming
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Department of Hepatobiliary Surgery, The 101th Hospital of Chinese PLA, Wuxi, Jiangsu, China (mainland).
authors.forename: Feng
authors.initials: F
authors.lastname: Yu
authors.affiliation: Department of Hepato-Biliary-Pancreato-Vascular Surgery, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China (mainland).
authors.forename: Lupeng
authors.initials: L
authors.lastname: Wu
authors.affiliation: Department of Hepato-Biliary-Pancreato-Vascular Surgery, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China (mainland).
authors.forename: Feng
authors.initials: F
authors.lastname: Ye
authors.affiliation: Department of Anaesthesiology, Second Hospital of Jilin University, Changchun, Jilin, China (mainland).
authors.forename: Leilei
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, Second Hospital of Lanzhou University, Lanzhou, Gansu, China (mainland).
authors.forename: Yumin
authors.initials: Y
authors.lastname: Li
mesh_terms: D000368:Aged; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013274:Stomach Neoplasms / Q000503:physiopathology / Q000601:surgery*; D015996:Survival Rate