Lymph node involvement as the only prognostic factor in curative resected gastric carcinoma: a multivariate analysis

Area of Science:

• Oncology
• Gastroenterology
• Surgical Pathology

Background:

• Gastric carcinoma presents a significant global health challenge with variable survival rates.
• Accurate prognostic factors are crucial for tailoring treatment and improving patient outcomes in gastric cancer.

Purpose of the Study:

• To determine the independent prognostic value of clinical and pathological variables in gastric carcinoma patients.
• To identify the most critical factor influencing survival following surgical resection for gastric cancer.

Main Methods:

• A retrospective analysis of 156 gastric carcinoma patients who underwent surgery.
• Application of Cox regression proportional hazard models for univariate and multivariate survival analyses.
• Evaluation of factors including age, symptoms, surgical procedure, tumor characteristics, and lymph node involvement (LNI).

Main Results:

• Univariate analysis identified numerous factors associated with poor survival, including advanced age, absence of specific symptoms, total gastrectomy, larger tumor size, lymph node involvement, deeper invasion, and specific tumor histology.
• Multivariate analysis revealed lymph node involvement (LNI) as the sole independent prognostic factor.
• Five-year survival rates varied significantly based on LNI status: 75.5% (no LNI), 28% (proximal LNI), and 7% (distal LNI).

Conclusions:

• Lymph node involvement is the most critical independent predictor of survival in gastric carcinoma patients undergoing curative resection.
• A staging system based on three lymph node involvement (LNI) groups offers the most effective approach for prognostication in curative settings.
• These findings underscore the importance of precise lymph node staging for optimizing treatment strategies and predicting outcomes in gastric cancer surgery.