Perigastric lymph node status can be a simple prognostic parameter in patients with gastric cancer

Background/Aims: The number of metastatic lymph nodes has been a significan t prognostic factor after curative resection of gastric cancer and adopted as a new UICC classification of nodal stages in gastric cancer. The extent of lymphadenectomy is another significant factor but has been fiercely deba ted. Regardless of the type of lymphadenectomy, perigastric lymph node diss ection is always carried out. In this study, we examined whether the number of metastatic perigastric nodes can be a prognostic indicator of gastric c ancer. Methodology: For the purpose of evaluating perigastric lymph node status, a retrospective study was carried out with 760 patients who underwent curati ve gastric resection from June 1994 to November 1998. Results: The 4-year cumulative survival rate was 64% and the survival rate decreased significantly when the number of positive perigastric nodes excee ded 3. Comparing with the patients having 0-2 positive perigastric nodes, p atients whose metastatic perigastric lymph nodes exceeded 3 or more exhibit ed deeper tumor invasion, larger tumor size and older age. Multivariate ana lysis identified the number of positive perigastric nodes, together with de pth of tumor invasion, as the strongest independent prognostic factors for survival. Conclusions: We suggest that the number of metastatic perigastric nodes can be used as a simple prognostic parameter in patients with gastric cancer a nd that intensive follow-up and adjuvant chemotherapy should be recommended for the patients with more than 3 metastatic perigastric nodes.