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Impact of total retrieved lymph nodes on staging and survival of patients with gastric cancer invading the subserosa
Surgical Oncology, 08/07/09

Liu C et al. - In a study to investigate the impact of total retrieved lymph nodes (tLNs) on staging and survival in pts with pT2b gastric cancer according to nodal status, it was concluded that to improve accuracy of staging, no less than 15 tLNs should be pathologically examined in pts with pN1–3, and 25 tLNs for pts with N0. More tLNs may not be associated with a better prognosis in pT2b disease because the extent of lymph node dissection is pre-defined for the operation.

Methods

Clinicopathological characteristics and prognostic outcomes of 392 pts with pT2b gastric cancer between 1980 and 2005 were retrospectively investigated based on the nodal status.

Results

Number of metastatic lymph nodes (mLNs) was highly correlated with the number of tLNs.
Overall 5-yr and 10-yr survival rates were 39.0% (153/392) and 17.9% (70/392), respectively.
Survival rates in pts with pN0 cancers did not differ significantly from that in pts with pN1 cancer when the tLNs were 25 or less.
Survival rate in pts with N0 cancers was significantly greater than that in pts with pN1 cancers when the tLNs were more than 25 (64.3% vs 36.9%).
Both 5- and 10-yr survival rates differed significantly among pts with pN1, pN2, and pN3 gastric cancer regardless of tLNs.
Multivariate analysis revealed that age, tumor focus number, tumor location, and mLN, but not tLNs, were independent prognostic predictors in pts with pT2b gastric cancer.

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