The prognostic value of lymph nodes count on survival of patients with node-negative gastric cancer.
The retrieved lymph node (LN) count has been validated as a prognostic factor in various cancers. However, the interaction between LN counts and patients' prognosis in gastric cancer with negative-LN metastasis is not fully studied. Surveillance, Epidemiology, and End Results Program (SEER)-registered gastric cancer patients were used for analysis in this study. Patients operated on for gastric cancer at N0 stage between 2004 and 2012 were identified from the SEER database. The association between the LN counts and survival was assessed using the Cox proportional hazards model. Patients were stratified into 1-4, 5-13, and > 13 subgroups according to LN count cut-off values determined by X-tile program, with the 5-year cause specific survival (CSS) rate of 64.8%, 72.5%, and 79.4%, respectively. LN count was also validated as an independently prognostic factor in multivariate Cox analysis (P < 0.001). In addition, nomograms including LN counts on CSS were established according to all significant factors, and the c-index was 0.703 (95% CI: 0.672-0.734). Further study indicated that patients with no LN metastasis had a decreased risk of death for each patient with LN examined up to approximately 14 LNs. Collectively, our study firmly demonstrated that the number of the retrieved LNs count was an independent prognostic factor for gastric cancer with no LN metastasis. The higher the LN count, the better the survival would be; the best CSS was observed on the LN count more than 14.
Department of Gastroenterology, Rui'an People's Hospital, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou 325200, Zhejiang Province, China.
Wei-Feng
WF
Zheng
Department of Gastroenterology, Rui'an People's Hospital, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou 325200, Zhejiang Province, China.
Ting-Ting
TT
Ji
Department of Gastroenterology, Rui'an People's Hospital, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou 325200, Zhejiang Province, China.
Yong
Y
Lin
Department of Gastroenterology, Rui'an People's Hospital, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou 325200, Zhejiang Province, China.
Rong-Zhou
RZ
Li
D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D000368:Aged; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D018426:SEER Program; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery
SEER; gastric cancer; lymph node count; survival analysis