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Surgical treatment and outcome for node-negative gastric cancer
Y Maehara1, M Tomoda, S Tomisaki
1Department of Surgery II, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Background:
The clinicopathologic characteristics and prognosis for patients with node-negative gastric cancer have heretofore remained to be determined.
Methods:
We analyzed data on 730 of our patients with node-negative gastric cancer who underwent curative gastric resection in the Department of Surgery II, Kyushu University Hospital, between 1965 and 1990, with reference to prognostic factors. The presence of lymph node metastasis was determined by means of routine hematoxylin-eosin staining of excised tissues.
Results:
The 5-year survival rate was 91.7% and the 10-year rate was 88.5%; thus the prognosis was good for patients with node-negative gastric cancer. When the prognosis was analyzed by stratification of each clinicopathologic factor, the survival time was shorter for older patients when the size of the tumor was larger, when the tumor involved the entire stomach, and when-tissues revealed infiltrative growth, serosal invasion, and lymphatic invasion. Extensive lymph node dissection was performed for 86.6% of the patients, and for these patients the prognosis was better, with a statistical difference. In a multivariate analysis, tumor size, serosal invasion, and extensive lymph node dissection proved to be independent prognostic factors for patients with node-negative gastric cancer.
Conclusions:
Prophylactic lymph node dissection for patients with gastric cancer will prolong the survival time.