Abstract
ABSTRACT Background: Nearly 10% of node negative gastric cancer patients who underwent curative surgery have disease recurrence. Western data is extremely poor on this matter and identifying the risk factors that associate with relapse may allow new strategies to improve survival. Aim: Verify the clinical and pathological characteristics that correlate with recurrence in node negative gastric cancer. Methods: All gastric cancer patients submitted to gastrectomy between 2009 and 2019 at our institution and pathologically classified as N0 were considered. Their data were available in a prospective database. Inclusion criteria were: gastric adenocarcinoma, node negative, gastrectomy with curative intent, R0 resection. Main outcomes studied were: disease-free survival and overall survival. Results: A total of 270 patients fulfilled the inclusion criteria. Mean age was 63-year-old and 155 were males. Subtotal gastrectomy and D2 lymphadenectomy were performed in 64% and 74.4%, respectively. Mean lymph node yield was 37.6. Early GC was present in 54.1% of the cases. Mean follow-up was 40.8 months and 19 (7%) patients relapsed. Disease-free survival and overall survival were 90.9% and 74.6%, respectively. Independent risk factors for worse disease-free survival were: total gastrectomy, lesion size ≥3.4 cm, higher pT status and <16 lymph nodes resected. Conclusion: In western gastric cancer pN0 patients submitted to gastrectomy, lymph node count <16, pT3-4 status, tumor size ≥3.4 cm, total gastrectomy and presence of lymphatic invasion, are all risk factors for disease relapse.
Highlights
Gastric cancer (GC) has high prevalence worldwide and is a major cause of cancer-related death[2,10,20]
Central message In western gastric cancer pN0 patients submitted to gastrectomy, lymph node count
Considering the extent of resection, pN0 GC patients who underwent total gastrectomy had worse disease-free survival compared with subtotal gastrectomy (p=0.001)
Summary
Gastric cancer (GC) has high prevalence worldwide and is a major cause of cancer-related death[2,10,20]. Lymph node metastasis is the most important prognostic factor[18,23,29]; nearly 10% of pN0 patients who underwent gastrectomy have disease recurrence[18,22,23,29]. This particular subgroup may benefit from adjuvant therapy and more intensive follow-up[22,26, 28]). The aim of this study was to evaluate the clinical and pathological characteristics related to recurrence in pN0 GC patients who underwent curative gastrectomy. The mean tumor size was 3 cm (0.2-14), and the cutoff value obtained by the ROC curve was 3.4 cm, with an accuracy of 66% (Figure 1)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
