Outcome in relation to numbers of nodes harvested in lymph node-positive gastric cancer

Aims

We conducted a retrospective case–control study to compare the prognostic differences of lymph node-positive gastric cancer patients between dissected lymph nodes (DLNs) < 15 group and DLNs ≥ 15 group.

Methods

A retrospective study of 323 lymph node-positive gastric patients who underwent potentially curative resection for gastric cancer was analyzed to identify the prognostic differences between DLNs < 15 group and DLNs ≥ 15 group. Of these patients, 49 patients with <15 DLNs were matched with 147 patients with ≥15 DLNs according to gender, age, location of primary tumor, and type of gastrectomy.

Results

Patients with n1 lymph node metastasis (according to JCGC), serosal involvement, ratio of positive lymph nodes less than 25%, or without adjuvant chemotherapy in ≥15 DLN group had comparatively longer median survival than patients with homologous clinicopathologic variables in <15 DLN group, respectively. Patients with n1 stage lymph node metastasis, serosal involvement, non-intestinal Lauren classification, or without adjuvant chemotherapy in <15 DLN group had higher recurrence rate than patients with homologous clinicopathologic variables in ≥15 DLN group, respectively. In addition, we demonstrated that patients with more than n1 stage lymph node metastasis in <15 DLN group had higher rate of peritoneal dissemination than those with more than n1 lymph node metastasis in ≥15 DLN group.

Conclusions

DNL ≥15 was an important factor to improve the prognosis of lymph node-positive gastric cancer patients after potential curative resection.