Clinicopathologic characteristics and outcome indicators in node-negative gastric cancer

Background and Objectives: The relationship between the number of lymph nod es examined and the outcome in patients with node-negative (N-) gastric can cer was studied. We compared N- patients to those with nodal involvement (N +) to identify clinicopathologic characteristics of N- gastric cancer. Fina lly, we evaluated outcome indicators in this group of patients. Methods: Of 367 patients, 130 (35.4%) were N-. These patients were stratifi ed according to the main prognostic variables, to assess differences with N + cases. A statistical analysis using the Cox model was performed to estima te outcome indicators. Results: N- gastric carcinomas were significantly different from N+ cases i n terms of tumor depth and site, TNM stage, grading, residual disease, and vessel involvement. The overall 5-year survival rate was 72%. It was 82% in those patients with more than 15 nodes retrieved and 59% in the others. Se rosal involvement, residual disease, and poor differentiation were independ ent prognostic factors. Conclusions: The clinicopathologic factors and outcome of N- cases were sim ilar to those of early gastric cancer. At least 15 examined nodes appears t o be necessary to define a case as N-. The prognostic value of D2 lymphaden ectomy in N- patients suggests a biologic role of micrometastases. (C) 2000 Wiley-Liss, Inc.