Impact of negative lymph node number on prognosis advanced cancer of cardiac and stomach fundus

Abstract

To analyze the impact of negative lymph node number on the prognosis of advanced cancer of the cardia and stomach fundus. 236 patients with advanced cancer of the cardia and stomach fundus underwent D2 radical resection. 5-year survival rate and recurrence rate were followed up and the relationships of lymph node (LN) number to 5-year survival rate and recurrence rate were analyzed respectively, according to LN count subgroups. The 5-year survival rate of the entire cohort was 37.5%. The number of metastasis negative LNs was positively correlated with the LNs examined (P < 0.05). For the cancer at the same stage, the higher the number of metastasis negative LNs the higher the 5-year survival rate (P < 0.05). Linear correlation analysis showed that along with the increase of the number of negative LNs the post-operative survival rate increased. In the cancers at the stages III and IV, the 5-year survival rate increased by 6.09% and 7.65% respectively compared to the predicted values (P = 0.013 and P = 0.035). The overall recurrence rate was 61.0% within 5 years after surgery. For the cancers at the stages III and IV, the more the number of negative LNs the higher the 5-year survival rates (P < 0.05). In the cancers at the stages II and IV there were significant differences in the recurrence rates among the subgroups with different numbers of negative LNs (all P < 0.002). Number of negative LNs has a close relation with stage-based survival prediction. Dissection of sufficient lymph nodes in the procedure of D2 dissection should be recommended so as to improve the long-term therapeutic effects and reduce the recurrence rate.