[PROGNOSTIC SURVIVAL FACTORS IN GASTRIC CANCER WITH NEGATIVE REGIONAL NODES]

This discriptive and retrospective study evaluated 44 patients with histological proven node negative gastric cancer who underwent subtotal gastrectomy (n=42) or total gastrectomy (n=2) at Hospital Belen, Trujillo, Peru, between 1966 and 1996. The main objective was to determine the prognostic factors which influenced the five-year survival rate. There were 23 male, and 21 female (M:F = 1.1:1). Mean age was 60 10 years (which ranged from 26 to 81 years). Pathology mean time was of 16.3 13.6 month (which ranged from 1 to 84 months). The types of lymph node dissections were Do (n=2), D1 (n=29), and D2/D3 (n=3). The postoperative mortality rate was of 15.9%. In the total series, the 5-year survival rate was of 38%; although, this rate increased to 56% in those patients who underwent D1D3 lymphadenectomy. According to univariate analysis, using the log-rank test, prognosis was related with serum level of hemoglobin (p<0.05), clinical stage (p<0.01), curability (p<0.01), and type of lymphadenectomy (p<0.05). The clinical course was not related to age, gender, length of disease, palpable mass, gastric outlet obstructive syndrome, digestive hemorrhage, tumor size, location, macroscopic type, tumor depth, nor histologic type. We concluded that an early detection, the feasibility of a curative resection, and an extended lymphadenectomy were factors that affected survival in an individual patient with gastric cancer without lymph node involvement. These parameters must be considered to stratify patients for an adjuvant treatment.