盆腔侧方淋巴结转移对低位直肠癌预后的影响

Objective To evaluate the prognostic value of lateral pelvic lymph node metastasis on low rectal cancer. Methods One hundred and seventy-six patients with low rectal cancer who underwent radical resection combined with lateral pelvic lymph node dissection between 1994 and 2005 were reviewed. The data of the cases was investigated to define the prognostic value of lateral pelvic lymph node metastasis on the patients. Results Lateral node metastasis occurred in 33 patients (18.8%), and 51.5% of the metastasis occurred in internal iliac nodes or nodes at middle rectal roots and 39.4% in obturator nodes. Age ≤40 years, infiltrative cancer, T3-4 tumor, upward lymph node metastasis were risk factors for lateral node metastasis in low rectal cancer (P ＜ 0.05). The overall 5-year survival rate was 64.1%, and it was 94.1%, 79.1%, 42.1% for patients with TNM stage Ⅰ , Ⅱ , Ⅲ cancer, respectively. Tumor size, depth of infiltration, upward lymph node metastasis, lateral node metastasis was correlated significantly with prognosis (P ＜ 0.05). The 5-year survival rate of the patients without lateral metastasis was 73.6%, which was significant higher than that of patients with lateral metastasis (21.4%, P ＜0.05). Conclusion Lateralpelvic lymph node metastasis is an important prognostic factor for low rectal cancer.     

盆腔侧方淋巴结转移对低位直肠癌预后的影响

Objective To evaluate the prognostic value of lateral pelvic lymph node metastasis on low rectal cancer. Methods One hundred and seventy-six patients with low rectal cancer who underwent radical resection combined with lateral pelvic lymph node dissection between 1994 and 2005 were reviewed. The data of the cases was investigated to define the prognostic value of lateral pelvic lymph node metastasis on the patients. Results Lateral node metastasis occurred in 33 patients (18.8%), and 51.5% of the metastasis occurred in internal iliac nodes or nodes at middle rectal roots and 39.4% in obturator nodes. Age ≤40 years, infiltrative cancer, T3-4 tumor, upward lymph node metastasis were risk factors for lateral node metastasis in low rectal cancer (P ＜ 0.05). The overall 5-year survival rate was 64.1%, and it was 94.1%, 79.1%, 42.1% for patients with TNM stage Ⅰ , Ⅱ , Ⅲ cancer, respectively. Tumor size, depth of infiltration, upward lymph node metastasis, lateral node metastasis was correlated significantly with prognosis (P ＜ 0.05). The 5-year survival rate of the patients without lateral metastasis was 73.6%, which was significant higher than that of patients with lateral metastasis (21.4%, P ＜0.05). Conclusion Lateralpelvic lymph node metastasis is an important prognostic factor for low rectal cancer.     

盆腔侧方淋巴结转移对低位直肠癌预后的影响

Objective To evaluate the prognostic value of lateral pelvic lymph node metastasis on low rectal cancer. Methods One hundred and seventy-six patients with low rectal cancer who underwent radical resection combined with lateral pelvic lymph node dissection between 1994 and 2005 were reviewed. The data of the cases was investigated to define the prognostic value of lateral pelvic lymph node metastasis on the patients. Results Lateral node metastasis occurred in 33 patients (18.8%), and 51.5% of the metastasis occurred in internal iliac nodes or nodes at middle rectal roots and 39.4% in obturator nodes. Age ≤40 years, infiltrative cancer, T3-4 tumor, upward lymph node metastasis were risk factors for lateral node metastasis in low rectal cancer (P ＜ 0.05). The overall 5-year survival rate was 64.1%, and it was 94.1%, 79.1%, 42.1% for patients with TNM stage Ⅰ , Ⅱ , Ⅲ cancer, respectively. Tumor size, depth of infiltration, upward lymph node metastasis, lateral node metastasis was correlated significantly with prognosis (P ＜ 0.05). The 5-year survival rate of the patients without lateral metastasis was 73.6%, which was significant higher than that of patients with lateral metastasis (21.4%, P ＜0.05). Conclusion Lateralpelvic lymph node metastasis is an important prognostic factor for low rectal cancer.     

盆腔侧方淋巴结转移对低位直肠癌预后的影响

Objective To evaluate the prognostic value of lateral pelvic lymph node metastasis on low rectal cancer. Methods One hundred and seventy-six patients with low rectal cancer who underwent radical resection combined with lateral pelvic lymph node dissection between 1994 and 2005 were reviewed. The data of the cases was investigated to define the prognostic value of lateral pelvic lymph node metastasis on the patients. Results Lateral node metastasis occurred in 33 patients (18.8%), and 51.5% of the metastasis occurred in internal iliac nodes or nodes at middle rectal roots and 39.4% in obturator nodes. Age ≤40 years, infiltrative cancer, T3-4 tumor, upward lymph node metastasis were risk factors for lateral node metastasis in low rectal cancer (P ＜ 0.05). The overall 5-year survival rate was 64.1%, and it was 94.1%, 79.1%, 42.1% for patients with TNM stage Ⅰ , Ⅱ , Ⅲ cancer, respectively. Tumor size, depth of infiltration, upward lymph node metastasis, lateral node metastasis was correlated significantly with prognosis (P ＜ 0.05). The 5-year survival rate of the patients without lateral metastasis was 73.6%, which was significant higher than that of patients with lateral metastasis (21.4%, P ＜0.05). Conclusion Lateralpelvic lymph node metastasis is an important prognostic factor for low rectal cancer.     

盆腔侧方淋巴结转移对低位直肠癌预后的影响

Objective To evaluate the prognostic value of lateral pelvic lymph node metastasis on low rectal cancer. Methods One hundred and seventy-six patients with low rectal cancer who underwent radical resection combined with lateral pelvic lymph node dissection between 1994 and 2005 were reviewed. The data of the cases was investigated to define the prognostic value of lateral pelvic lymph node metastasis on the patients. Results Lateral node metastasis occurred in 33 patients (18.8%), and 51.5% of the metastasis occurred in internal iliac nodes or nodes at middle rectal roots and 39.4% in obturator nodes. Age ≤40 years, infiltrative cancer, T3-4 tumor, upward lymph node metastasis were risk factors for lateral node metastasis in low rectal cancer (P ＜ 0.05). The overall 5-year survival rate was 64.1%, and it was 94.1%, 79.1%, 42.1% for patients with TNM stage Ⅰ , Ⅱ , Ⅲ cancer, respectively. Tumor size, depth of infiltration, upward lymph node metastasis, lateral node metastasis was correlated significantly with prognosis (P ＜ 0.05). The 5-year survival rate of the patients without lateral metastasis was 73.6%, which was significant higher than that of patients with lateral metastasis (21.4%, P ＜0.05). Conclusion Lateralpelvic lymph node metastasis is an important prognostic factor for low rectal cancer.     

盆腔侧方淋巴结转移对低位直肠癌预后的影响

Objective To evaluate the prognostic value of lateral pelvic lymph node metastasis on low rectal cancer. Methods One hundred and seventy-six patients with low rectal cancer who underwent radical resection combined with lateral pelvic lymph node dissection between 1994 and 2005 were reviewed. The data of the cases was investigated to define the prognostic value of lateral pelvic lymph node metastasis on the patients. Results Lateral node metastasis occurred in 33 patients (18.8%), and 51.5% of the metastasis occurred in internal iliac nodes or nodes at middle rectal roots and 39.4% in obturator nodes. Age ≤40 years, infiltrative cancer, T3-4 tumor, upward lymph node metastasis were risk factors for lateral node metastasis in low rectal cancer (P ＜ 0.05). The overall 5-year survival rate was 64.1%, and it was 94.1%, 79.1%, 42.1% for patients with TNM stage Ⅰ , Ⅱ , Ⅲ cancer, respectively. Tumor size, depth of infiltration, upward lymph node metastasis, lateral node metastasis was correlated significantly with prognosis (P ＜ 0.05). The 5-year survival rate of the patients without lateral metastasis was 73.6%, which was significant higher than that of patients with lateral metastasis (21.4%, P ＜0.05). Conclusion Lateralpelvic lymph node metastasis is an important prognostic factor for low rectal cancer.     

盆腔侧方淋巴结转移对低位直肠癌预后的影响

Objective To evaluate the prognostic value of lateral pelvic lymph node metastasis on low rectal cancer. Methods One hundred and seventy-six patients with low rectal cancer who underwent radical resection combined with lateral pelvic lymph node dissection between 1994 and 2005 were reviewed. The data of the cases was investigated to define the prognostic value of lateral pelvic lymph node metastasis on the patients. Results Lateral node metastasis occurred in 33 patients (18.8%), and 51.5% of the metastasis occurred in internal iliac nodes or nodes at middle rectal roots and 39.4% in obturator nodes. Age ≤40 years, infiltrative cancer, T3-4 tumor, upward lymph node metastasis were risk factors for lateral node metastasis in low rectal cancer (P ＜ 0.05). The overall 5-year survival rate was 64.1%, and it was 94.1%, 79.1%, 42.1% for patients with TNM stage Ⅰ , Ⅱ , Ⅲ cancer, respectively. Tumor size, depth of infiltration, upward lymph node metastasis, lateral node metastasis was correlated significantly with prognosis (P ＜ 0.05). The 5-year survival rate of the patients without lateral metastasis was 73.6%, which was significant higher than that of patients with lateral metastasis (21.4%, P ＜0.05). Conclusion Lateralpelvic lymph node metastasis is an important prognostic factor for low rectal cancer.     

盆腔侧方淋巴结转移对低位直肠癌预后的影响

Objective To evaluate the prognostic value of lateral pelvic lymph node metastasis on low rectal cancer. Methods One hundred and seventy-six patients with low rectal cancer who underwent radical resection combined with lateral pelvic lymph node dissection between 1994 and 2005 were reviewed. The data of the cases was investigated to define the prognostic value of lateral pelvic lymph node metastasis on the patients. Results Lateral node metastasis occurred in 33 patients (18.8%), and 51.5% of the metastasis occurred in internal iliac nodes or nodes at middle rectal roots and 39.4% in obturator nodes. Age ≤40 years, infiltrative cancer, T3-4 tumor, upward lymph node metastasis were risk factors for lateral node metastasis in low rectal cancer (P ＜ 0.05). The overall 5-year survival rate was 64.1%, and it was 94.1%, 79.1%, 42.1% for patients with TNM stage Ⅰ , Ⅱ , Ⅲ cancer, respectively. Tumor size, depth of infiltration, upward lymph node metastasis, lateral node metastasis was correlated significantly with prognosis (P ＜ 0.05). The 5-year survival rate of the patients without lateral metastasis was 73.6%, which was significant higher than that of patients with lateral metastasis (21.4%, P ＜0.05). Conclusion Lateralpelvic lymph node metastasis is an important prognostic factor for low rectal cancer.     

盆腔侧方淋巴结转移对低位直肠癌预后的影响

Objective To evaluate the prognostic value of lateral pelvic lymph node metastasis on low rectal cancer. Methods One hundred and seventy-six patients with low rectal cancer who underwent radical resection combined with lateral pelvic lymph node dissection between 1994 and 2005 were reviewed. The data of the cases was investigated to define the prognostic value of lateral pelvic lymph node metastasis on the patients. Results Lateral node metastasis occurred in 33 patients (18.8%), and 51.5% of the metastasis occurred in internal iliac nodes or nodes at middle rectal roots and 39.4% in obturator nodes. Age ≤40 years, infiltrative cancer, T3-4 tumor, upward lymph node metastasis were risk factors for lateral node metastasis in low rectal cancer (P ＜ 0.05). The overall 5-year survival rate was 64.1%, and it was 94.1%, 79.1%, 42.1% for patients with TNM stage Ⅰ , Ⅱ , Ⅲ cancer, respectively. Tumor size, depth of infiltration, upward lymph node metastasis, lateral node metastasis was correlated significantly with prognosis (P ＜ 0.05). The 5-year survival rate of the patients without lateral metastasis was 73.6%, which was significant higher than that of patients with lateral metastasis (21.4%, P ＜0.05). Conclusion Lateralpelvic lymph node metastasis is an important prognostic factor for low rectal cancer.     

盆腔侧方淋巴结转移对低位直肠癌预后的影响

Objective To evaluate the prognostic value of lateral pelvic lymph node metastasis on low rectal cancer. Methods One hundred and seventy-six patients with low rectal cancer who underwent radical resection combined with lateral pelvic lymph node dissection between 1994 and 2005 were reviewed. The data of the cases was investigated to define the prognostic value of lateral pelvic lymph node metastasis on the patients. Results Lateral node metastasis occurred in 33 patients (18.8%), and 51.5% of the metastasis occurred in internal iliac nodes or nodes at middle rectal roots and 39.4% in obturator nodes. Age ≤40 years, infiltrative cancer, T3-4 tumor, upward lymph node metastasis were risk factors for lateral node metastasis in low rectal cancer (P ＜ 0.05). The overall 5-year survival rate was 64.1%, and it was 94.1%, 79.1%, 42.1% for patients with TNM stage Ⅰ , Ⅱ , Ⅲ cancer, respectively. Tumor size, depth of infiltration, upward lymph node metastasis, lateral node metastasis was correlated significantly with prognosis (P ＜ 0.05). The 5-year survival rate of the patients without lateral metastasis was 73.6%, which was significant higher than that of patients with lateral metastasis (21.4%, P ＜0.05). Conclusion Lateralpelvic lymph node metastasis is an important prognostic factor for low rectal cancer.     

早期胃癌临床病理特征与预后因素的分析

目的：探讨早期胃癌临床病理特征与预后的关系。方法：采用单因素与多因素的分析方法，回顾性分析1994年至2000年间在我院接受手术且有完整临床资料和随访结果的137例早期胃癌病人的临床病理特征及其对预后的影响。结果：单因素分析显示肿瘤大小、浸润深度及淋巴结转移与早期胃癌的预后相关。多因素分析提示淋巴结转移是早期胃癌预后的独立危险因素。在本组无淋巴结转移的早期胃癌病人中，其术后5年生存率为93．2％，显著优于淋巴结转移者；其中有1～3枚淋巴结转移者，术后5年生存率为88．9％；有4枚及以上淋巴结转移者．术后5年生存率仅为30％，（P〈0．05）。血行转移是早期胃癌病人术后复发的主要类型。结论：淋巴结转移是影响早期胃癌预后的重要指标，术前评估早期胃癌的淋巴结转移状态有助于选择合理的治疗方案。应重视早期胃癌病人的术后随访。     

淋巴结检出数和淋巴结转移度对Ⅱ～Ⅲ期结直肠癌患者预后的影响

目的 探讨淋巴结检出数和淋巴结转移度（LNR）对Ⅱ～Ⅲ期结直肠癌患者预后的影响.方法 回顾性分析507例Ⅱ～Ⅲ期结直肠癌患者的临床病理资料和随访资料.结果 507例患者共计检出淋巴结5801枚;转移淋巴结1122枚;淋巴结转移数与检出数呈正相关（r=0.171,P＜0.01）.淋巴结检出数大于或等于12枚与小于12枚的Ⅱ期患者,5年生存率分别为80.5%和62.7%,差异有统计学意义（P＜0.01）;而Ⅲ期患者则差异无统计学意义（P＞0.05）.不同LNR的Ⅱ～Ⅲ期结直肠癌患者5年生存率差异有统计学意义（P＜0.01）.不同淋巴结转移区域的同一LNR组患者的5年生存率差异也有统计学意义（P＜0.05,P＜0.01）.结论 淋巴结检出数对Ⅱ期结直肠癌患者预后的影响更为明显.为了获得更准确的分期及更好的预后,术中应尽量检出12枚/例以上淋巴结.LNR是Ⅱ～Ⅲ期结直肠癌的预后因素,用其评估患者预后时应兼顾淋巴结转移区域.     

淋巴结清扫数对进展期G3级胃癌预后的影响分析

目的 探讨进展期低分化（G3级）胃癌预后的相关因素及淋巴结清扫数对其预后的影响.方法 回顾性分析2002年12月至2007年8月复旦大学附属中山医院收治并手术的484例进展期G3级胃癌患者的临床资料,分析年龄、肿瘤浸润深度、肿瘤部位、淋巴结清扫数、淋巴结阳性数、淋巴结转移率和脉管癌栓对患者预后的影响.结果 G3级胃癌患者清扫淋巴结数是否达到15枚对淋巴结转移数、淋巴结转移率、脉管癌栓、临床分期及5年生存率均有显著影响（均P＜0.05）;多因素预后分析显示,肿瘤浸润深度、淋巴结清扫数、淋巴结转移率和脉管癌栓是其独立的预后因素（均P＜0.05）.进展期G3级胃癌淋巴结清扫大于或等于20枚/例组患者的预后优于少于20枚/例组（P＜0.01）.结论 肿瘤浸润深度、淋巴结清扫数、淋巴结转移率和脉管癌栓是评估进展期G3级胃癌预后的重要因素,淋巴结清扫数目应至少达到20枚以保证胃癌淋巴结清扫术的质量,改善患者预后.     

Pelvic lymph node dissection for penile carcinoma: extent of inguinal lymph node involvement as an indicator for pelvic lymph node involvement and survival

PURPOSE: We identified pathological parameters of inguinal lymph node involvement with the aim of predicting pelvic lymph node involvement and survival. MATERIALS AND METHODS: A total of 308 patients with penile carcinoma and adequate followup were included in this study. The outcome of 102 patients who underwent lymphadenectomy for lymph node metastases was analyzed further. Histopathological characteristics of the regional lymph nodes were reviewed including unilateral or bilateral involvement, the number of involved nodes, pathological tumor grade of the involved nodes, and the presence of extracapsular growth. RESULTS: Tumor grade of the involved inguinal lymph nodes (OR 6.0, 95% CI 1.2-30.3) and the number of involved nodes (2 or less vs more than 2) (OR 12.1, 95% CI 3.0-48.1) were independent prognostic factors for pelvic lymph node involvement. Extracapsular growth (OR 2.3, 95% CI 1.1-4.8), bilateral inguinal involvement OR 3.4, 95% CI 1.2-9.4) and pelvic lymph node involvement (OR 3.1, 95% CI 1.4-6.6) were independent prognostic factors for disease specific survival. CONCLUSIONS: Patients with only 1 or 2 inguinal lymph nodes involved without extracapsular growth and no poorly differentiated tumor within these nodes are at low risk of pelvic lymph node involvement and have a good prognosis with a 5-year survival rate of approximately 90%. Pelvic lymph node dissection seems to be unnecessary in these cases.     

Significance of Long-Term Follow-Up of Early Gastric Cancer

Background Therapeutic outcomes for most patients with early gastric cancer are favorable. However, mortality among these patients remains a concern. Improvements in therapeutic outcomes are being sought by studying the timing and causes of death. Here, the results of surgery were evaluated to assess the appropriate treatment and follow-up schedule for early gastric cancer. Methods A total of 1169 patients with early gastric cancer underwent curative gastrectomy between 1992 and 1999. Survival time, prognostic factors, cause of death, and time of death were evaluated retrospectively. Results Multivariate analysis of disease-specific survival identified lymph node metastasis as an independent prognostic factor. The anatomical extent of lymph node metastasis and the number of metastatic lymph nodes influenced the rate of recurrence. Multivariate analysis of overall survival identified age as a prognostic factor. A total of 91 patients (7.8%) from the study group died: 56 from comorbid diseases, 21 from gastric cancer, and 14 from other second primary cancers. Death from gastric cancer was frequently observed within 5 years of surgical resection, whereas death from other diseases usually occurred after 5 years. Patients who died as a result of diseases other than gastric cancer tended to be older. Conclusions Appropriate lymph node dissection is necessary for patients with early gastric cancer, particularly those with risk factors associated with lymph node metastasis. Meticulous follow-up protocols that can detect second primary cancers, together with the development of treatments for comorbid diseases, are required to improve survival.     

Extracapsular lymph node involvement is a negative prognostic factor in T3 adenocarcinoma of the distal esophagus and gastroesophageal junction

OBJECTIVE: To assess prognosis according to whether lymph node involvement is intracapsular or with extracapsular breakthrough in adenocarcinoma of the distal esophagus and gastroesophageal junction.Materials and methods One hundred ninety-five consecutive patients with T3 adenocarcinoma of the distal esophagus and gastroesophageal junction between 1990 and 1999 were studied. All patients underwent primary R0 esophagectomy. The mean number of resected nodes per patient was 36.9. Survival was analyzed according to intracapsular and extracapsular involvement. RESULTS: In N0 patients 5-year survival was 57% and 9-year survival was 38.7%. In patients with positive nodes these figures were 26.2% and 18.1%, respectively (P =.0069). Intracapsular and extracapsular node involvement showed 5- and 10-year survival of 40.9% and 21.7% versus 18% and 15.7%, respectively. There was no significant difference in 5- and 10-year survival between N0 and intracapsular node involvement (P =.43). However, there was a significant difference in survival between N0 and extracapsular node involvement (P =.002) and between intracapsular and extracapsular node involvement (P =.0001). CONCLUSIONS: This study shows a significant difference in survival according to whether lymph node involvement was intracapsular or extracapsular. Patients with intracapsular lymph node involvement have similar survival rates as N0 patients. Extracapsular lymph node involvement is a bad prognostic factor, independent of the number of involved lymph nodes. The number of involved lymph nodes has an additive negative effect. These data may have an impact on treatment strategies.     

224例无淋巴结转移的进展期胃癌预后因素分析

目的探讨无淋巴结转移的进展期胃癌预后危险因素。方法回顾性分析福建省立医院1998—2008年10年间行D2胃癌根治术的236例淋巴结清扫数目在12枚以上、无淋巴结转移（N0期）的进展期胃癌患者的临床病理资料。结果本组患者中224例（94．9％）接受了随访,其5年总体生存率和5年无瘤生存率分别为75．2％和66．4％。T2期和T3期患者的复发率分别为5．8％（8／138）和14．0％（12／86）：5年总体生存率分别为82．5％和59．0％;5年无瘤生存率分别为70．4％和52．2％：差异均有统计学意义（均P〈0．05）。单因素预后分析显示,浸润深度、Lauren分型及淋巴结清扫数目与本组胃癌患者预后有关（P〈0．05）。多因素预后分析证实,浸润深度是本组患者的独立预后因素（P〈0．05）。结论T2N0期胃癌患者的预后明显优于T3N0期患者;对N0期胃癌患者决定是否行辅助治疗及制定随访策略时应考虑浸润深度这一因素。     

Evaluation of prognostic significance in extracapsular spread of lymph node metastasis in patients with gastric cancer

BACKGROUND: Extracapsular spread of lymph node metastasis has been shown as a negative prognostic factor in cancers of several other organs. This study was performed to clarify the prognostic significance of extracapsular spread in patients receiving curative resection for gastric cancer. METHODS: Extracapsular spread was defined as infiltration of cancer cells beyond the capsule of the metastatic lymph node. Four hundred and two patients who underwent curative gastrectomy were evaluated. Eight potential prognostic factors, including the International Union Against Cancer (Union International Contra la Cancrum; [UICC]) N stage and nodal status classified by the presence of lymph node metastasis or extracapsular spread, were examined. RESULTS: Three survival curves grouped by nodal status differed significantly, and prognosis of patients with extracapsular spread was significantly worse than for the other groups. Both UICC N stage ( P < .001) and nodal status ( P < .001) were significant prognostic factors by multivariate analysis. UICC N stages were subcategorized by nodal status, and survival was shown to be significantly worse in patients with extracapsular spread in the UICC N1 group ( P = .04). CONCLUSIONS: Extracapsular spread was a significant negative prognostic indicator on multivariate analysis, and may be useful in combination with UICC N stage. Extracapsular spread was regarded as an important indicator to refine the nodal staging system in gastric cancer.     

An evaluation of malignancy and prognostic factors based on mode of lymph node metastasis in esophageal carcinoma

This study was conducted to evaluate lymph node metastasis as a key prognostic factor in esophageal cancer. Metastatic lesions in lymph nodes were grouped by histological morphology as intracapsular or extracapsular, and the significance of lymph node metastasis was evaluated by relating metastatic lesions to clinical pathologic factors and patient prognosis. In our hospital, 46 of 81 patients who underwent resection of esophageal cancer developed lymph node metastasis. These 46 patients were enrolled in a study analyzing the relationship between the metastatic mode and the clinicopathological factors. The frequency of extracapsular metastasis was significantly high in patients with a profound depth of cancer, three or more metastases, distant metastasis (n3 and n4), or severe lymphatic invasion. The prognosis was significantly worse in patients with extracapsular metastasis, and this tendency was also seen even in patients with three or more metastases, limited metastasis (n1 and n2), or mild lymphatic invasion (ly0 and ly1). These findings suggest that the metastatic mode reflects the degree of esophageal cancer progression and is an important prognostic factor.     

淋巴结转移率对胃癌患者预后的影响

目的 探讨淋巴结转移率(rN)在胃癌患者预后评估中的价值.方法 对比分析319例接受胃癌根治术且清扫的淋巴结总数大于或等于15枚胃癌患者的临床资料,探讨rN与胃癌预后的关系.结果 本研究中将rN按0、<30%、30%～60%及>60%分为4组,各组2年生存率分别为84.4%、66.1%、35.0%、15.1%;3年生存率分别为80.5%、45.0%、15.0%、5.5%;4年生存率分别为71.4%、33.0%、5.0%、1.4%,差异均有统计学意义(P<0.05),与预后有良好的一致性.将同一pN分期组与rN分组比较,各组预后之间的差异均无统计学意义.COX多因素分析结果显示rN是影响胃癌预后的独立指标,其与肿瘤浸润深度、手术方式及肿瘤部位有相关性.结论 rN分级可更好地指导胃癌的治疗和预后判断,有助于完善胃癌的TNM分期体系.