• Online ISSN : 2313-1519
  • Print    ISSN : 1812-2892
Abstract - Are the type of gastrectomy and the presence of complications prognostic factors in patients with gastric cancer without lymph node involvement?
< Back
Orhan Uzun, Selçuk Gülmez, Aziz Serkan Senger, Cem Batuhan Ofluoğlu, Tolga Olmez, Hilmi Bozkurt, Erdal Polat, Mustafa Duman


Objective: Lymph node involvement is one of the leading prognostic factors in patients with gastric cancer without distant metastasis, although disease-related death also occurs in patients without lymph node involvement. The present study investigates whether gastrectomy type and complication presence is a prognostic factor in gastric cancer patients without lymph node involvement.

Material and methods: The data of 262 patients who underwent curative gastrectomy at our clinic between November 2006 and December 2018 was reviewed retrospectively.

Results: No lymph node involvement was identified in 33.2% of the patients who underwent curative gastrectomy, and survival in this group was better than in the patient group with lymph node involvement (75.9% vs. 32.6%). A comparison of the two groups revealed significant differences in terms of Borrmann’s classification, Lauren classification, T stage, vascular invasion, perineural invasion, tumor diameter and total number of lymph nodes. Disease-related death occurs also in patients without lymph node involvement, with tumor diameter, T stage, gastrectomy type and the presence of complications all found to be factors affecting the risk of death.

Conclusion: Patients without lymph node involvement have a better prognosis, and aside from tumor diameter and T stage, the present study found gastrectomy type and the presence of complications to be prognostic risk factors.

Key words: negative lymph nodes, prognostic factors, gastric cancer, overall survival

Corresponding author: Orhan Uzun, Gastroenterolgical Surgery Department, University of Health Sciences, Kartal Koşuyolu High Specialty Training and Research Hospital. Address: Denizer Street, Cevizli crossroad, Cevizli, Kartal, Istanbul, Turkey. Post code: 34865. Tel.: +905052592674. E-mail: orhuzu@hotmail.com




1. Stewart C, Chao J, Chen Y.J, et al. Multimodality management of locally advanced gastric cancer—the timing and extent of surgery. Transl Gastroenterol Hepatol. 2019; 4:42-42. doi:10.21037/tgh.2019.05.02

2. Marano L, Polom K, Patriti A, et al. Surgical management of advanced gastric cancer: An evolving issue. Eur J Surg Oncol. 2016; 42(1):18-27. doi:10.1016/j.ejso.2015.10.016

3. Zhou Y, Cui J, Huang F, et al. Scandinavian journal of surgery SJS Prognostic Factors For survival in node-negative gastric cancer Patients Who underWent curative resection. Scand J Surg. 2017; 106(3):235-40. doi:10.1177/1457496916677878

4. Zhao B, Huang X, Zhang J, et al. Clinicopathologic factors associated with recurrence and long-term survival in node-negative advanced gastric cancer patients. Rev Esp Enferm Dig. 2019; 111(2):111-20. doi:10.17235/reed.2018.5829/2018

5. Jin LX, Moses LE, Hart Squires M, et al. Factors associated with recurrence and survival in lymph node-negative gastric adenocarcinoma: A 7-institution study of the us gastric cancer collaborative. Annals of Surgery. Lippincott Williams and Wilkins. 2015; 999-1005. doi:10.1097/SLA.0000000000001084

6. Japanese gastric cancer treatment guidelines 2010 (ver. 3). Japanese Gastric Cancer Association. 2011. doi:10.1007/s10120-011-0040-6

7. Sun P, Xiang J, Chen Z. Meta-analysis of adjuvant chemotherapy after radical surgery for advanced gastric cancer. 2009; 26-33. doi:10.1002/bjs.6408

8. Siewert JR, Bottcher K, Stein HJ, et al. Relevant Prognostic Factors in Gastric Cancer Ten-Year Results of the German Gastric Cancer Study. Ann Surg. 1998; 228(4):449-61. doi: 10.1097/00000658-199810000-00002.

9.   Meyer C, Lozac’h P, Rohr S, et al. French Association of Surgery. Gastric cancer: the French survey. Acta Gastroenterol Belg. 65(3):161-5.

10. Wohnrath DR, Araujo RLC. D2 lymphadenectomy for gastric cancer as an independent prognostic factor of 10-year overall survival. Eur J Surg Oncol. 2019; 45(3):446-53. doi:10.1016/j.ejso.2018.10.538

11. Aurello P, Berardi G, Tierno SM, et al. Influence of perineural invasion in predicting overall survival and disease-free survival in patients With locally advanced gastric cancer. Am J Surg. 2017; 213(4):748-53. doi:10.1016/j.amjsurg.2016.05.022

12. Wang H-M, Huang C-M, Zheng C-H, et al. Tumor size as a prognostic factor in patients with advanced gastric cancer in the lower third of the stomach. World J Gastroenterol. 2012; 18(38):5470-5. doi:10.3748/wjg.v18.i38.5470

13. Donida MGBM, Ratti LTM, Benzoni CPI, Aldighieri DLF. Prognostic factors associated with survival in a large cohort of gastric cancer patients resected over a decade at a single Italian center : the Cremona experience. Clin Transl Oncol. 2019; (0123456789). doi:10.1007/s12094-019-02220-w

14. Li X, Zhu X, Wang Y, et al. Prognostic value and association of Lauren classification with VEGF and VEGFR-2 expression in gastric cancer. Oncol Lett. 2019; 18(5):4891-9. doi:10.3892/ol.2019.10820

15.Cortesini C. Clinicopathologic Characteristics and Outcome Indicators in Node-Negative. 2000; (September 1999):30-2. doi:10.1002/1096-9098(200005)74:1<30::AID-JSO7>3.0.CO;2-2

16. Qiu MZ, Wang ZQ, Luo HY, et al. Prognostic analysis in node-negative gastric cancer patients in China. Tumor Biol. 2011; 32(3):489-2. doi:10.1007/s13277-010-0142-5

17. Liu X, Cai H, Shi Y, Wang Y. Prognostic Factors in Patients with Node-Negative Gastric Cancer: A Single Center Experience from China. J Gastrointest Surg. 2012; 16(6):1123-7. doi:10.1007/s11605-012-1881-y

18. Hsu J Te, Le PH, Kuo CJ, et al. Survival impact of the number of lymph node retrieved on patients with node-negative gastric cancer: More is better? Transl Gastroenterol Hepatol. 2017; 2. doi:10.21037/tgh.2017.12.02

19. Deng J, You Q, Gao Y, et al. Prognostic value of perineural invasion in gastric cancer: A systematic review and meta-analysis. PLoS One. 2014; 9(2). doi:10.1371/journal.pone.0088907

20. Deng J, Liang H, Sun DM, et al. Prognosis of Gastric Cancer Patients with Node-Negative Metastasis Following Curative Resection: Outcomes of the Survival and Recurrence.

21. Lee EW, Lee WY, Koo HS. Prognostic factors for node-negative advanced gastric cancer after curative gastrectomy. J Gastric Cancer. 2016; 16(3):161-6. doi:10.5230/jgc.2016.16.3.161

22. Lee CC, Wu CW, Lo SS, et al. Survival predictors in patients with node-negative gastric carcinoma. J Gastroenterol Hepatol. 2007; 22(7):1014-8. doi:10.1111/j.1440-1746.2006.04488.x

Volume 4, Number 58 (2020)