Clinicopathologic features of the patients with node-negative metastasis gastric adenocarcinoma and their survival analysis / 中华胃肠外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the clinicopathologic features of the patients with node-negative metastasis (pN0) gastric carcinoma confirmed by routine pathologic examination (Ha&E staining),and their relationship with survival.</p><p><b>METHODS</b>The clinico-pathologic data of 87 pN0 gastric carcinoma patients were analyzed retrospectively. Kaplan-Meier (Log-rank) method was used to compare the survival rate,and Cox regression method was used to screen the independent prognosis factors for pN0 gastric cancer.</p><p><b>RESULTS</b>There were 69 males and 18 females. D(2) lymphadenectomy was performed in 75 (86.2%), and D(3) in 13 cases (13.8%). Distal gastrectomy was performed in 59 (67.8%), total gastrectomy in 24 (27.6%) and proximal gastrectomy in l4 cases (4.6%). Twenty-three (26.4%) cases received postoperative chemotherapy and 64 (73.6% ) did not. The 5-year survival rate of the 87 pN0 gastric carcinoma patients was 56.5%. There were no differences in survival rate considering age, tumor location, gastrectomy, lymph nodes dissection, differentiation grade, and tumor-stroma relationship (P > 0.05), while the differences were significant in survival rate between the patients with postoperative chemotherapy,lymphatic invasion,venous invasion or not,and different pT staging (all Pa< 0.05). The Cox regression analysis revealed that pT staging and postoperative chemotherapy were independent prognostic factors.</p><p><b>CONCLUSION</b>pT staging and postoperative chemotherapy are independent prognostic factors. It is necessary to develop a precise staging technique to select a suitable surgical therapy or confirm which patients should accept postoperative chemotherapy in pN0 gastric carcinoma patients.</p>