Research Papers:

Increased number of negative lymph nodes is associated with improved survival outcome in node positive gastric cancer following radical gastrectomy

Rong-liang Shi, Qian Chen, Jun Bing Ding, Zhen Yang, Gaofeng Pan, Daowen Jiang _ and Weiyan Liu

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Oncotarget. 2016; 7:35084-35091. https://doi.org/10.18632/oncotarget.9041

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Rong-liang Shi1,2,3,*, Qian Chen1,*, Jun Bing Ding1, Zhen Yang1, Gaofeng Pan1, Daowen Jiang1,4, Weiyan Liu1

1Department of General Surgery, Minhang Hospital, Fudan University, Shanghai, People’s Republic of China

2Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China

3Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People’s Republic of China

4Department of Thoracic Surgery, Minhang Hospital, Fudan University, Shanghai, People’s Republic of China

*These authors have contributed equally to this work

Correspondence to:

Daowen Jiang, e-mail: [email protected]

Weiyan Liu, e-mail: [email protected]

Keywords: gastric cancer, negative lymph node, SEER

Received: February 06, 2016     Accepted: April 15, 2016     Published: April 27, 2016


The concept of negative lymph node (NLN) counts has recently attracted attention as a prognostic indicator in various cancer. However, the correlation between NLN counts and patient prognosis in the setting of gastric cancer is not fully studied. Surveillance, Epidemiology, and End Results Program (SEER)-registered gastric cancer patients were used for analysis in this study. Clinicopathological characteristics, including race, age, gender, and tumor stage, grade, and cause specific survival were collected. Univariate and multivariate Cox proportional hazards model were used to assess the risk factors for survival. As results, X-tile plots identified 3 and 9 as the optimal cutoff value to divide the patients into high, middle and low risk subsets in terms of cause specific survival, and NLN was validated as independently prognostic factor in mulivariate Cox analysis (P < 0.001). Further analysis showed that NLN was a prognosis factor in each N stage. Collectively, our study results firmly demonstrated that the number of NLNs was an independent prognostic factor for gastric cancer patients, and together with the N stage, it could provide more accurate prognostic information than the N stage alone.

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