Prognostic Significance of the Number of Metastatic Lymph Nodes after Curative Resection in Patients with Gastric Cancer

Abstract

Gastric cancer is the most common cause of cancer death in Korea, and the most important prognostic factor for patients with gastric cancer is the extent of TNM stage. Among TNM staging system, lymph node involvement (N) has been recognized as one of the significant prognostic indicators after curative resection. Recently, nodal stage of new AJCC TNM staging system has changed its emphasis on the location of metastatic lymph nodes to the number of metastatic lymph nodes. Thus, we attempted to analyze the survival difference based on the number of metastatic lymph nodes after curative resection of gastric cancer. Two hundred and forty two patients of curatively resected gastric cancer were retrospectively studied to identify the number of metastatic lymph nodes to influence prognosis. The following results were obtained. The results showed that there was a significant difference in the survival rate between the patients with 0-2 metastatic lymph nodes and those with ≥3 metastatic lymph nodes in adjuvant chemotherapy (FA) group (DFS; 36.7% vs. 23.4%, OS; 38.3% vs. 26.0%). In adjuvant chemoimmunotherapy (FA+poly-AU) group, there was a significant difference in the overall survival between the patients with 0∼2 metastatic lymph nodes and those with ≥ 3 metastatic lymph nodes(70.1% vs. 47.4%). The present report demonstrates the prognostic importance of the number of metastatic lymph nodes in gastric cancer after curative resection and a necessity of further evaluation of current nodal stage.