Kim DY, Seo KW, Joo JK, Park YK, Ryu SY, Kim HR, Kim YJ, Kim SK. Prognostic factors in patients with node-negative gastric carcinoma: A comparison with node-positive gastric carcinoma. World J Gastroenterol 2006; 12(8): 1182-1186 [PMID: 16534868 DOI: 10.3748/wjg.v12.i8.1182]
Corresponding Author of This Article
Dr Dong Yi Kim, Division of Gastroenterologic Surgery, Department of Surgery, Chonnam National University Medical School, Gwangju, Korea. dockim@jnu.ac.kr
Article-Type of This Article
Gastric Cancer
Open-Access Policy of This Article
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World J Gastroenterol. Feb 28, 2006; 12(8): 1182-1186 Published online Feb 28, 2006. doi: 10.3748/wjg.v12.i8.1182
Table 1 Clinical features of patients with node-negative and -positive gastric carcinoma
Variables
Node-negative(n = 1524) (%)
Node-positive(n = 1324) (%)
P value
Age (mean, yr)
56.9 ± 11.1
57.1 ± 11.6
NS
Gender
NS
Male
988 (64.8)
889 (67.1)
Female
536 (35.2)
435 (32.9)
Extent of lymph node dissection
NS
<D2
262 (17.2)
246 (18.6)
≥D2
1,262 (82.8)
1,078 (81.4)
Operative type
< 0.001
Total gastrectomy
251 (16.5)
383 (28.9)
Subtotal gastrectomy
1,226 (80.4)
902 (68.1)
Proximal gastrectomy
12 (0.8)
3 (0.3)
Others
35 (2.3)
36 (2.7)
Curability
< 0.001
Curative
1,492 (97.9)
1,024 (77.3)
Non-curative
32 (2.1)
300 (22.7)
Recurrence
< 0.001
Locoregional
29 (13.2)
46 (8.5)
Peritoneum
163 (74.1)
480 (88.4)
Others
28 (12.7)
17 (3.1 )
Table 2 Histopathologic features of node-negative and -positive gastric carcinoma
Variables
Node-negative(n = 1524) (%)
Node-positive(n = 1324) (%)
P value
Tumor size (mean, cm)
2.9 ± 2.0
5.0 ± 2.7
< 0.001
Location
NS
Upper
123 (8.1)
141 (10.7)
Middle
443 (29.0)
358 (27.0)
Lower
946 (62.1)
783 (59.1)
Whole
12 (0.8)
42 (3.2)
Macroscopic appearance
NS
EGC
Elevated
161 (20.0)
27 (24.1)
Depressed
572 (71.2)
69 (61.6)
Flat
71 (8.8)
16 (14.3)
Borrmann type
< 0.001
1
47 (6.5)
54 (4.5)
2
183 (25.4)
218 (18.0)
3
441 (61.3)
812 (67.0)
4
49 (6.8)
128 (10.5)
Depth of invasion
< 0.001
T1
804 (52.8)
112 (8.5)
T2
343 (22.5)
170 (12.8)
T3
338 (22.1)
856 (64.7)
T4
39 (2.6)
186 (14.0)
Hepatic metastasis
< 0.001
H (-)
1,519 (99.7)
1,269 (95.8)
H (+)
5 (0.3)
55 (4.2)
Peritoneal dissemination
< 0.001
P (-)
1,509 (99.0)
1,179 (89.0)
P (+)
15 (1.0)
145 (11.0)
Histologic type
<0.001
Well-differentiated
355 (23.3)
165 (12.5)
Moderately differentiated
352 (23.1)
339 (25.6)
Poorly differentiated
536 (35.1)
642 (48.5)
Signet ring cell
189 (12.4)
59 (4.5)
Mucinous
53 (3.5)
95 (7.1)
Others
39 (2.6)
24 (1.8)
Stage
<0.001
I
1,145 (75.1)
91 (6.9)
II
324 (21.3)
124 (9.4)
III
30 (2.0)
689 (52.0)
IV
25 (1.6)
420 (31.7)
Table 3 Prognostic significance by univariate analysis of variables for patients with lymph node-negative gastric carcinoma
Variables
5-year survival (%)
P value
Age (yr)
< 0.01
< 65
79.1
≥ 65
70.7
Gender
NS
Male
74.4
Female
81.3
Tumor size (cm)
< 0.001
< 2.0
88.5
2 - 4.9
79.2
≥ 5
53.6
Depth of invasion
< 0.001
T1, T2
88.4
T3, T4
55.4
Location
< 0.001
Upper third
49.9
Middle third
67.9
Lower third
62.3
Histologic type
NS
Differentiated
78.4
Undifferentiated
75.7
Operative type
< 0.001 NS
Total
61.5
Subtotal
80.9
Extent of lymph node dissection
< D2
67.6
≥ D2
77.3
Stage
< 0.001
I
88.4
II
61.5
III
17.9
IV
22.3
Table 4 Multivariate analysis of significant prognostic factors for survival in lymph node negative gastric carcinoma patients using Cox proportional hazard regression model
Variables
Risk ratio
95% CI
P value
Age(yr) (< 65 vs ≥65)
1.354
0.95-1.92
NS
Gender (male vs female)
0.923
0.66-1.28
NS
Location (upper vs distal)
0.731
0.49-1.09
NS
Tumor size (mm) (< 50 vs ≥50)
1.513
1.06-2.21
< 0.05
Histologic type (differentiated vs. undifferentiated)
0.749
0.55-1.02
NS
Serosal invasion (negative vs positive)
3.409
2.42-4.80
< 0.001
Extent of lymph node dissection (< D2 vs ≥ D2)
1.188
0.56-2.50
NS
Curability (curative vs non-curative)
3.84
2.11-7.00
< 0.001
Esophageal invasion (negative vs positive)
1.007
0.34-2.97
NS
Citation: Kim DY, Seo KW, Joo JK, Park YK, Ryu SY, Kim HR, Kim YJ, Kim SK. Prognostic factors in patients with node-negative gastric carcinoma: A comparison with node-positive gastric carcinoma. World J Gastroenterol 2006; 12(8): 1182-1186