Increased number of negative lymph nodes is associated with improved survival outcome in node positive gastric cancer following radical gastrectomy
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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
Daowen Jiang, e-mail: firstname.lastname@example.org
Weiyan Liu, e-mail: email@example.com
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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