Perigastric lymph node status can be a simple prognostic parameter in patients with gastric cancer

The number of metastatic lymph nodes has been a significant prognostic factor after curative resection of gastric cancer and adopted as a new UICC classification of nodal stages in gastric cancer. The extent of lymphadenectomy is another significant factor but has been fiercely debated. Regardless of the type of lymphadenectomy, perigastric lymph node dissection is always carried out. In this study, we examined whether the number of metastatic perigastric nodes can be a prognostic indicator of gastric cancer.

For the purpose of evaluating perigastric lymph node status, a retrospective study was carried out with 760 patients who underwent curative gastric resection from June 1994 to November 1998.

The 4-year cumulative survival rate was 64% and the survival rate decreased significantly when the number of positive perigastric nodes exceeded 3. Comparing with the patients having 0-2 positive perigastric nodes, patients whose metastatic perigastric lymph nodes exceeded 3 or more exhibited deeper tumor invasion, larger tumor size and older age. Multivariate analysis identified the number of positive perigastric nodes, together with depth of tumor invasion, as the strongest independent prognostic factors for survival.

We suggest that the number of metastatic perigastric nodes can be used as a simple prognostic parameter in patients with gastric cancer and that intensive follow-up and adjuvant chemotherapy should be recommended for the patients with more than 3 metastatic perigastric nodes.