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Prognostic significance of intraoperative chemotherapy and extensive lymphadenectomy in patients with node-negative gastric cancer

Authors

  • Jin Wang MD,

    1. Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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  • Jian-Chun Yu MD,

    Corresponding author
    1. Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
    • Peking Union Medical College Hospital, No. 1 Shuai Fu Yuan, Dongcheng District, Beijing 100730, China. Fax: 0086-10-65296038.
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  • Wei-Ming Kang MD,

    1. Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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  • Zhi-Qiang Ma MD

    1. Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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  • The authors have no financial disclosures to declare and no conflicts of interest to report.

  • Jin Wang conceived the study, analyzed data, and drafted the manuscript. Jian-Chun Yu revised the manuscript critically for important intellectual content. Wei-Ming Kang and Zhi-Qiang Ma helped in collecting data. All authors read and approved the final manuscript.

Abstract

Background and Objectives

Despite a relatively better prognosis, patients with node-negative gastric cancer still suffer from metastasis and recurrence. To investigae the prognostic factors and appropriate therapies for these pN0 tumors, we analyzed the predictors and evaluated the impact of chemotherapy and extensive lymphadenectomy on survival.

Methods

Clinicopathologic features of 153 patients with pN0 gastric cancer were studied retrospectively. The prognostic factors were analyzed stratifying by pT1 and pT2–3 stage. The 5-year survival rate (5-YSR) of patients in different groups of chemotherapy and lymph nodes retrieved were compared.

Results

Multivariate analysis indicated pT, number of nodes retrieved, and chemotherapy as the independent predictors of advanced gastric cancer; anemia was the only independent predictor of early gastric cancer. Survival of patients with pT3 got improved significantly by intraoperative chemotherapy and retrieval of more than 25 nodes, but neither of them benefited patients with pT1–2. Moreover, in pT3 status, 5-YSR of patients with intraoperative chemotherapy was still poorer than those with postoperative chemotherapy and combined chemotherapy.

Conclusions

In pN0 gastric cancers, prognostic factors differed significantly between early stage and advanced stage. For patients with pT3, besides curative gastrectomy and postoperative chemotherapy, it might be beneficial to perform intraoperative chemotherapy and extensive lymphadenectomy. J. Surg. Oncol. 2012;105:400–404. © 2011 Wiley Periodicals, Inc.

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