Department of Surgical Oncology, Cancer Institute (WIA), Chennai-600036, India.
World J Surg Oncol. 2011 May 10;9:48. doi: 10.1186/1477-7819-9-48.
The status of the regional nodes is the most important prognostic factor in gastric cancer. There are subgroups of patients with different prognosis even in node-negative patients of gastric cancer. The aim of this study is to analyze the factors influencing the prognosis in Indian patients with node-negative gastric cancer.
This was a retrospective analysis of patients who underwent radical gastrectomy in a tertiary cancer centre in India between 1991 and 2007. The study group included only patients with histologically node-negative disease. Various clinical, pathological and treatment related factors in this group of patients were analyzed to determine their prognostic ability by univariate and multivariate analyses.
Among the 417 patients who underwent gastrectomy during this period, 122 patients had node-negative disease. A major proportion of the patients had advanced gastric cancer. The 5-year overall survival and disease-free survival in all node-negative gastric cancer patients was 68.2% and 67.5% respectively. The overall recurrence rate in this group was 27.3%. On univariate analysis, the factors found to significantly influence the disease-free survival were the size, location and presence or absence of serosal invasion of the primary tumor. However, on multivariate analysis, only tumor size more than 3 cm and serosal invasion were found to be independently associated with an inferior survival.
Serosal invasion and primary tumor size more than 3 cm independently predict a poor outcome in patients with node-negative gastric cancer.
区域淋巴结状态是胃癌最重要的预后因素。即使在淋巴结阴性的胃癌患者中，也存在预后不同的亚组患者。本研究旨在分析影响印度淋巴结阴性胃癌患者预后的因素。
这是对 1991 年至 2007 年间在印度一家三级癌症中心接受根治性胃切除术的患者进行的回顾性分析。研究组仅包括组织学淋巴结阴性疾病的患者。通过单因素和多因素分析，分析该组患者的各种临床、病理和治疗相关因素，以确定其预后能力。
在此期间接受胃切除术的 417 名患者中，有 122 名患者患有淋巴结阴性疾病。大多数患者患有晚期胃癌。所有淋巴结阴性胃癌患者的 5 年总生存率和无病生存率分别为 68.2%和 67.5%。该组的总体复发率为 27.3%。单因素分析发现，显著影响无病生存率的因素是原发肿瘤的大小、位置和有无浆膜侵犯。然而，多因素分析发现，只有肿瘤大小超过 3 厘米和浆膜侵犯与生存不良独立相关。
浆膜侵犯和原发肿瘤大小超过 3 厘米独立预测淋巴结阴性胃癌患者预后不良。
