Prognostic significance of immunohistochemical micrometastases in node negative gastric cancer patients

Background and Objectives: The purpose of this study is to examine the prog nostic significance of immunohistochemical (THC) evidence of lymph node (LN ) metastases in histologic node negative gastric cancer patients. Methods: Retrospective review from 1981 to 1998 revealed 25 patients resect ed for T1-4N0M0 gastric and gastroesophageal (GE) junction adenocarcinoma. All cases were reviewed and histopathologic parameters were defined for eac h primary tumor. All LNs underwent IHC analysis with the epithelial marker CAM 5.2. Data are reported as median (range). Results: The median number of LN resected was 7 (range 1-33). The median fo llow-up time was 25 months (range 4-195) with an overall 5-year survival ra te of 55%. For patients with IHC evidence of LN micrometastasis (n = 9), th e 5-year survival rate was significantly decreased (35%) compared to a 66% 5-year survival rate for IHC negative patients (n = 16, P = 0.05). Conclusions: The presence of IHC-detected LN micrometastases correlates wit h worse prognosis for patients with histologic node negative gastric cancer . IHC may be a useful additional staging modality in this subset of patient s. (C) 2000 Wiley-Liss, Inc.