Brief Articles
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Aug 21, 2009; 15(31): 3926-3930
Published online Aug 21, 2009. doi: 10.3748/wjg.15.3926
Prognostic impact of dissected lymph node count on patients with node-negative gastric cancer
Chang-Ming Huang, Jian-Xian Lin, Chao-Hui Zheng, Ping Li, Jian-Wei Xie, Bi-Juan Lin, Hui-Shan Lu
Chang-Ming Huang, Jian-Xian Lin, Chao-Hui Zheng, Ping Li, Jian-Wei Xie, Bi-Juan Lin, Hui-Shan Lu, Department of Oncology, Affiliated Union Hospital, Fujian Medical University, No. 29 Xinquan Road, Fuzhou 350001, Fujian Province, China
Author contributions: Huang CM and Lin JX conceived of the study, analyzed the data, and drafted the manuscript; Lu HS helped critically revising the manuscript for important intellectual content; Zheng CH, Li P, Xie JW and Lin BJ helped collecting the data and designing the study.
Correspondence to: Chang-Ming Huang, Professor, Department of Oncology, Affiliated Union Hospital, Fujian Medical University, No. 29 Xinquan Road, Fuzhou 350001, Fujian Province, China. hcmlr253@sohu.com
Telephone: +86-591-83363366
Fax: +86-591-83320319
Received: June 23, 2009
Revised: July 16, 2009
Accepted: July 23, 2009
Published online: August 21, 2009
Abstract

AIM: To investigate the long-term effect of the number of resected lymph nodes (LNs) on the prognosis of patients with node-negative gastric cancer.

METHODS: Clinical data of 211 patients with gastric cancer, without nodal involvement, were analyzed retrospectively after D2 radical operation. We analyzed the relationship between the number of resected LNs with the 5-year survival, the recurrence rate and the post-operative complication rate.

RESULTS: The 5-year survival of the entire cohort was 82.2%. The total number of dissected LNs was one of the independent prognostic factors. Among patients with comparable depth of invasion, the larger the number of resected LNs, the better the survival (P < 0.05). A cut-point analysis provided the possibility to detect a significant survival difference among subgroups. Patients had a better long-term survival outcomes with LN counts ≥ 15 for pT1-2, ≥ 20 for pT3-4, and ≥ 15 for the entire cohort. The overall recurrence rate was 29.4% within 5 years after surgery. There was a statistically significant, negative correlation between the number of resected LNs and the recurrence rate (P < 0.01). The post-operative complication rate was 10.9% and was not significantly correlated with the number of dissected LNs (P > 0.05).

CONCLUSION: For node-negative gastric cancer, sufficient number of dissected LNs is recommended during D2 lymphadenectomy, to improve the long-term survival and reduce the recurrence. Suitable increments of the dissected LN count would not increase the post-operative complication rate.

Keywords: Stomach neoplasms; Lymph nodes; Gastrectomy; Lymphadenectomy; Prognosis