The value of negative lymph node count in T3 gastric cancer / 中华普通外科杂志

ABSTRACT

Objective To evaluate negative lymph node count (NLNC) in prediction of prognosis of T3 gastric cancer after radical resection.Method 214 T3 patients of radical gastrectomy with complete clinical and follow-up data between Jan 2003 to Dec 2007 were enrolled.Survival was determined by the Kaplan-Metier method and univariate analysis was done by Log-rank test,Multivariate analysis was performed using the COX proportional hazard regression model.-2loglikelihood value and the hazard ratio (HR) value were used to compared the value of number of lymph node-negative (NLNC) staging and pN staging and lymph node metastasis rate (MLR) in gastric cancer prognosis evaluation.Results Univariate analysis showed that,pN stage (x2 =31.664),MLR stage (x2 =34.123),tumor size (x2 =5.025),type of differentiation (x2 =5.993),Borrmann classification (x2 =5.401),NLNC stage (x2 =37.256) were related to survival (P ＜ 0.05).COX multivariate analysis showed that-2loglikelihood of pN staging is 1 336.761,HR value is 1.464,-2loglikelihood value of MRL staging is 1 335.821,HR value is 1.441.-2loglikelihood value of NLNC staging is 1 326.902,HR value is 1.725.The N0 and N1 staging prognosis in different NLNC staging was significant (P =0.008,P =0.014).Conclusions Sufficient number of negative lymph node prolongs survival and reduces the risk of early recurrence in advanced gastric cancer.