Clinical Research Papers:

Negative lymph node count is a significant prognostic factor in patient with stage IV gastric cancer after palliative gastrectomy

Changhua Zhuo _, Mingang Ying, Ruirong Lin, Xianyi Wu, Shen Guan and Chunkang Yang

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Oncotarget. 2017; 8:71197-71205. https://doi.org/10.18632/oncotarget.17430

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Changhua Zhuo1, Mingang Ying1, Ruirong Lin1, Xianyi Wu1, Shen Guan1 and Chunkang Yang1

1Department of Gastrointestinal Surgical Oncology, Fujian Provincial Key Laboratory of Tumor Biotherapy, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou 350014, China

Correspondence to:

Chunkang Yang, email: [email protected]

Keywords: gastric cancer, palliative resection, negative lymph node, survival analysis, prognostic factor

Received: February 22, 2017    Accepted: March 27, 2017    Published: April 26, 2017


Negative lymph node (NLN) count has been validated as a protective predictor in various cancers after radical resection. However, the prognostic value of NLN count in the setting of stage IV gastric cancer patients who have received palliative resection has not been investigated. Surveillance, Epidemiology, and End Results Program (SEER)-registered gastric cancer patients were used for analysis in this study. Kaplan-Meier survival curves and multivariate Cox proportional hazards model were used to assess the risk factors for patients’ survivals. The results showed that NLN count and N stage were independently prognostic factors in patients with stage IV gastric cancer after palliative surgery (P< 0.001). X-tile plots identified 2 and 11 as the optimal cutoff values to divide the patients into high, middle and low risk subsets in term of cause-specific survival (CSS). And NLN count was proved to be an independently prognostic factor in multivariate Cox analysis (P< 0.001). The risk score of NLN counts demonstrated that the plot of hazard ratios (HRs) for NLN counts sharply increased when the number of NLN counts decreased. Collectively, our present study revealed that NLN count was an independent prognostic predictor in stage IV gastric cancer after palliative resection. Standard lymph node dissection, such as D2 lymphadectomy maybe still necessary during palliative resection for patients with metastatic gastric cancer.

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