The Impact Of The Resected Lymph Node Numbers On The Prognosis Of Gastric Cancer In Different Stage

Objective To investigate the appropriate lymph node dissection range of radical surgery of gastric cancer and evaluate the Significance of radical lymphadenectomy of gastric cancer,by studying the relationship between the patients with the different numbers of lymph nodes resected during radical lymphadenectomy and their prognosis in gastric carcinoma, and analyzing the factors that affect the prognosis of gastric cancer.Methods Retrospectively analyzed the prognostic data from419gastric cancer patients who underwent radical surgery of gastric cancer in Qi Lu Hospital of Shan Dong university from June2007to February2010.The prognosis of the patients with different numbers of lymph nodes resected during radical lymphadenectomy was compared.Results Using univariate analysis, it shows that the numbers of resected lymph nodes, tumor size, cell differentiation, and both pN stages and T stage of UICC, were significantly correlated with the overall survival of the gastric cancer patients following radical surgery, while tumor location, age, sex and surgical methods were not correlated. According to5th edition UICC(Union International Contre le Cancer)TNM stage, there are114patients in Ⅰ stage,79patients in Ⅱ stage,139patients in Ⅲ stage,42patients in Ⅳ stage.(1)①Tere are108patients with more than25lymph nodes were resected,heir12-month,36-month,48-month survival rate are98.5%、79.9%、40.5%.②Tere are190patients with the number of resected lymph nodes among15to25, their12-month、36-month、48-month survival rate are97.3%、64.6%、29.2%.③Tere are76patients with less than15lymph nodes were resected, their12-month、36-month、48-month survival rate are97.3%、64.6%、29.2%. The difference among those patients with different numbers of resected lymph nodes is statistically significant(P<0.05).(2) The patients who belong to I stage, their12-month36-month、48-month survival rate are93.3%、73.3%、55.0%,when less than15lymph nodes were resected; the patients with the numbers of resected lymph nodes among15to25, their12-month、36-month、48-month survival rate are100%、97.2%、73.5%;The others who were resected more than25lymph nodes, their12-month、36-month、48-month survival rate are100%、91.6%、73.3%. The difference of survival rate between the patients with less than those15lymph nodes were resected and those with the numbers of resected lymph nodes among15to25or those with more than25lymph nodes were resected is statistically significant(P<0.05). The difference of survival rate between the patients with the numbers of resected lymph nodes among15to25and those with more than25lymph nodes were resected is not statistically significant (P=0.87) in I stage.(3) while patients in Ⅱ、 Ⅲ or Ⅳ stage their12-month,36-month,48-month survival rate are higher as more lymph nodes were resected. In other words, patients in Ⅱ、 Ⅲ or Ⅳ stage, their prognosis is better as the number of resected lymph nodes increasing In a certain range.The difference among all groups is statistically significant(P<0.05).Conclusion The lymph node dissection of gastric cancer is very necessary, More than15Lymph nodes resected can significantly improve the prognosis of patients; For patients in I stage, the appropriate number of resected lymph node is16to25;Patients in Ⅱ、 Ⅲ or Ⅳ stage the number of resected lymph node should more than25.