Prognostic factors for patients with node-negative gastric cancer: Can extended lymph node dissection have a survival benefit?
BACKGROUND AND OBJECTIVES: For the patients with node-negative gastric cancer, there is no agreement on which clinicopathological factors influence the final results except T stage. The aim of this study was to investigate the prognostic factors, and to reveal whether the extent of lymph node dissection is associated with survival benefit for these patients. METHODS: Clinicopathological data of 506 patients with node-negative gastric cancer were studied. We divided the patients into D1 and D2 groups and carried out univariate and multivariate survival analyses. RESULTS: On the univariate analysis, the factors influencing survival were age, tumor size, Borrmann type, resection type, and the T stage. However, multivariate analysis with the Cox proportional hazard model disclosed age and the T stage to be significant variables. The extent of lymphadenectomy was revealed to be the independent prognostic factors for survival only for the patients with T3 stage. CONCLUSIONS: For the patients with clinically node-negative gastric cancer, an extended D2 lymph node dissection for the patients with T1 and T2 stage has no survival benefits. Although it might have some benefit for T3 stage by multivariate analysis, we should ascertain its value through a large randomized prospective study.