Abstract
BackgroundThe status of the regional nodes is the most important prognostic factor in gastric cancer. There are subgroups of patients with different prognosis even in node-negative patients of gastric cancer. The aim of this study is to analyze the factors influencing the prognosis in Indian patients with node-negative gastric cancer.MethodsThis was a retrospective analysis of patients who underwent radical gastrectomy in a tertiary cancer centre in India between1991 and 2007. The study group included only patients with histologically node-negative disease. Various clinical, pathological and treatment related factors in this group of patients were analyzed to determine their prognostic ability by univariate and multivariate analyses.ResultsAmong the 417 patients who underwent gastrectomy during this period, 122 patients had node-negative disease. A major proportion of the patients had advanced gastric cancer. The 5-year overall survival and disease-free survival in all node-negative gastric cancer patients was 68.2% and 67.5% respectively. The overall recurrence rate in this group was 27.3%. On univariate analysis, the factors found to significantly influence the disease-free survival were the size, location and presence or absence of serosal invasion of the primary tumor. However, on multivariate analysis, only tumor size more than 3 cm and serosal invasion were found to be independently associated with an inferior survival.ConclusionSerosal invasion and primary tumor size more than 3 cm independently predict a poor outcome in patients with node-negative gastric cancer.
Highlights
The status of the regional nodes is the most important prognostic factor in gastric cancer
More than 80% of the patients had advanced gastric cancer and D2 lymphadenectomy was performed in 81% of the patients
Conclusion patients with node-negative gastric cancers had a favorable survival in our study, the subgroup of patients with a tumor size more than 3 cm or tumors invading the serosa had a worse prognosis when compared to those having smaller tumors or those without serosal invasion
Summary
The status of the regional nodes is the most important prognostic factor in gastric cancer. There are subgroups of patients with different prognosis even in node-negative patients of gastric cancer. The aim of this study is to analyze the factors influencing the prognosis in Indian patients with node-negative gastric cancer. The status of the regional lymph nodes is the most important prognostic factor in gastric cancer and patients with node-negative gastric cancer have a better survival compared to those with nodal metastasis [1,2]. Even among the node-negative patients, there are certain subgroups of patients who fare better than the others [3,4,5,6,7,8,9,10,11,12,13]. While many previous studies on node-negative gastric cancer have
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