Gastric cancer: prognosis and lymph node reactivity.

OBJECTIVE

To assess the prognostic value of various immunomorphological variables in the prognosis of gastric cancer after curative resection.

DESIGN

Retrospective study.

SETTING

University hospital, Italy.

SUBJECTS

180 Patients who underwent curative resection for carcinoma of the distal two thirds of stomach between January 1960 and December 1978. Curative was defined as no residual cancer at the resection margins and no distant metastases.

INTERVENTIONS

All living patients were followed-up, and missing survival data were obtained from the Official Census Registry.

MAIN OUTCOME MEASURES

Correlation between survival and nuclear grade, lymphocytic infiltration, and types of lymph node reaction such as sinus histiocytosis, paracortical lymphoid cellular hyperplasia, and follicular hyperplasia in the cortical area.

RESULTS

Crude 5 year and 10 year survival rates were 46% and 36%, respectively. Sex, site, and histological type of the tumour did not correlate with survival. Multivariate analysis showed that only pTNM stage of disease and degree of sinus histiocytosis were significantly related to survival.

CONCLUSION

There may be an argument for using the presence or absence of sinus histiocytosis to stratify patients in prospective studies of adjuvant treatment.