Survival of Node-Positive Mucosal Gastric Carcinoma Patients

Cho, Yong Chul; Kim, Ho Goon; Jung, Mi Ran; Ryu, Seong Yeob; Park, Young Kyu; Kim, Dong Yi; Kim, Young Jin

Abstract

PURPOSE: The presence or absence of lymph node metastasis is significantly associated with the survival of patients with gastric carcinoma. We compared node-positive and node-negative mucosal gastric carcinoma patients to identify the clinicopathological characteristics of node-positive mucosal gastric carcinoma. We also evaluated the variables associated with lymph node metastasis and survival in this group of patients.
METHODS
Of the 580 mucosal gastric carcinoma patients, 32 (5.5%) were node-positive. A statistical analysis using the Cox model was performed to determine the factors that can predict the patients' outcomes.
RESULTS
The mean tumor size was significantly larger in the patients with node-positive mucosal gastric carcinoma than that in the node-negative patients (3.3 vs. 1.8 cm; P<0.001). The overall survival rate was lower for the patients who were node-positive than for the patients who were node-negative (83.3% vs. 91.4%, respectively), but the difference was not significant (P>0.05). Using the Cox proportional hazard regression model, tumor size was an independent statistically significant parameter associated with lymph node metastasis (risk ratio: 4.70, 95% confidence interval: 1.20 to 18.35; P<0.05).
CONCLUSION
Tumor size is the most reliable predictor of lymph node metastasis for patients with node-positive mucosal gastric carcinoma. Nevertheless, a large tumor size is not associated with a poor outcome for patients with node-positive mucosal gastric carcinoma. The patients with node-positive mucosal gastric carcinoma showed good survival rates after undergoing gastrectomy and extensive node dissection.