Factors correlated with number of metastatic lymph nodes in gastric cancer

Objective: We had previously reported a reasonable categorization of the nu mber of positive lymph nodes (LN: 0, 1-4, 5-8, and > 8) as a prognostic ind icator. This study was an extension, to see which factors correlated with n umber of positive lymph nodes. Methods: A total of 533 patients with gastri c adenocarcinoma, who underwent curative surgery between January 1988 and D ecember 1995, were entered into this study. Patients were divided into four groups according to metastatic LN number (0, 1-4, 5-8, and > 8). Their sur vival and clinicopathological factors were analyzed. Results: A total of 16 ,457 LNs, with an average of 30.9 per specimen, were removed, of which 1686 (10.2%) showed metastases. The 5-yr cumulative survival rate decreased as the number of metastatic LNs increased, i.e., 91.3% for LN 0; 67.4% for LN 1-4; 37.2 for LN 5-8, and 14.1% for LN > 8. Multivariate analyses showed th at depth of cancer invasion (odds ratio: 2.4), gross appearance (odds ratio : 1.9), size (odds ratio: 1.9), and location (odds ratio: 1.4) of tumor wer e four independent factors correlated with the number of metastatic LNs. Nu mber of metastatic LNs increased with advanced Japanese nodal stage and UIC C-TNM stage. Conclusions: Depth of tumor invasion, and gross appearance, si ze, and location of tumor were four pathological factors independently corr elated with number of metastatic LNs in gastric cancer. (C) 1999 by Am. Cel l. of Gastroenterology.