Number of lymph node metastases and its prognostic significance in early gastric cancer: A multicenter italian study

Journal of Surgical Oncology - Tập 94 Số 4 - Trang 275-280 - 2006
Franco Roviello1, Símone Rossi1, Daniele Marrelli1, Corrado Pedrazzani1, Giovanni Corso1, Carla Vindigni2, Paolo Morgagni3, Luca Saragoni4, Giovanni De Manzoni5, Anna Tomezzoli6
1Dipartimento di Chirurgia Generale ed Oncologica, Università di Siena, Siena, Italia
2Istituto di Anatomia Patologica, Università di Siena, Siena, Italia
3Dipartimento di Chirurgia Generale, Ospedale G.B. Morgagni, Forlì, Italia
4Servizio di Anatomia Patologica, Ospedale L. Pierantoni, Forlì, Italia
5Dipartimento di Chirurgia Generale, Università di Verona, Verona, Italia
6Servizio di Anatomia Patologica, Università di Verona, Verona, Italia

Tóm tắt

AbstractBackground and ObjectivesThis study was aimed at evaluating the prognostic significance of the number of metastatic nodes in early gastric cancer (EGC).MethodsIn this multicenter retrospective study 652 cases of resected EGC were analyzed. We searched for lymph node metastases‐associated risk factors and to identify subsets of patients with different prognosis according to the number of involved nodes.ResultsNodal involvement was observed in 14.1%. A significant correlation was found between the presence of node metastases and tumor size (RR 1.34, P = 0.001), submucosal invasion (RR: 3.14, P = 0.007), Lauren diffuse/mixed type (RR: 4.88, P < 0.001) and Kodama Pen A type (RR: 4.59, P < 0.001). The 10‐year survival rate was 92% for N0 cases, 82% and 73% for tumors with one to three and four to six positive nodes while it dropped to 27% with more than six metastatic nodes. Interestingly enough, the 10‐year risk of recurrence diminished with the increasing number of retrieved nodes (>15) even in N0 patients.ConclusionsNodal involvement confirmed to be a significant prognostic factor. In view of the trend to a lower risk of recurrence when more than 15 nodes were retrieved and the better staging achieved we consider D2 lymphadenectomy the treatment of choice. J. Surg. Oncol. 2006;94:275–280. © 2006 Wiley‐Liss, Inc.

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Journal of Surgical Oncology

Tập 94 Số 4

275-280

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