Prognostic factors and availability of D2 lymph node dissection for the patients with stage II gastric cancer: Comparative analysis of subgroups in stage II

Joong Min Park, Jong Han Kim, Sungsoo Park, Seung Joo Kim, Young Jae Mok, Chong Suk Kim

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Abstract

Background: According to the fifth edition of the UICC TNM classification, stage II gastric cancer has three subgroups: T1N2M0, T2N1M0, and T3N0M0. This study was designed to investigate the prognosis of stage II gastric cancer according to the T and N category to verify the accuracy of TNM staging for stage II and to determine the prognostic factors for patients with stage II gastric cancer by subgroup. Methods: Clinicopathologic data from 326 patients with stage II gastric cancer were studied. We stratified the patients into T2N1 and T3N0 groups and performed comparative analysis between the two groups as well as univariate and multivariate survival analyses for each group. Results: The five-year survival rate for patients with T2N1 disease was 75.6%, whereas for patients with T3N0 disease it was 68.3%. There was no significant difference in survival between T2N1 and T3N0 groups (p = 0.174). Univariate survival analysis showed that age, gender, histological type, and the extent of lymph node dissection were significant prognostic factors for stage II gastric cancer. However, multivariate analysis demonstrated that only gender and the extent of lymph node dissection were significant variables. Among these variables, gender was an independent prognostic factor for survival only in the T2N1 group. On the other hand, the extent of lymph node dissection was an independent prognostic factor in the T3N0 group, not in the T2N1 group. Conclusions: There was no significant difference in survival between the T2N1 and the T3N0 groups. Thus, our data support the accuracy of the TNM staging classification for stage II gastric cancer. We found a significant survival benefit with D2 dissection for T3N0 but not T2N1. However, before recommending limited lymph node dissection for T2N1 stage disease, development of a preoperative method for prediction of depth of invasion and lymph node status is needed.

Original languageEnglish
Pages (from-to)1037-1044
Number of pages8
JournalWorld Journal of Surgery
Volume32
Issue number6
DOIs
Publication statusPublished - 2008 Jun 1

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Lymph Node Excision
Stomach Neoplasms
Neoplasm Staging
Survival
Survival Analysis
Multivariate Analysis
Dissection
Survival Rate
Lymph Nodes

ASJC Scopus subject areas

  • Surgery

Cite this

@article{01050176c46749888e9748a36f325105,
title = "Prognostic factors and availability of D2 lymph node dissection for the patients with stage II gastric cancer: Comparative analysis of subgroups in stage II",
abstract = "Background: According to the fifth edition of the UICC TNM classification, stage II gastric cancer has three subgroups: T1N2M0, T2N1M0, and T3N0M0. This study was designed to investigate the prognosis of stage II gastric cancer according to the T and N category to verify the accuracy of TNM staging for stage II and to determine the prognostic factors for patients with stage II gastric cancer by subgroup. Methods: Clinicopathologic data from 326 patients with stage II gastric cancer were studied. We stratified the patients into T2N1 and T3N0 groups and performed comparative analysis between the two groups as well as univariate and multivariate survival analyses for each group. Results: The five-year survival rate for patients with T2N1 disease was 75.6{\%}, whereas for patients with T3N0 disease it was 68.3{\%}. There was no significant difference in survival between T2N1 and T3N0 groups (p = 0.174). Univariate survival analysis showed that age, gender, histological type, and the extent of lymph node dissection were significant prognostic factors for stage II gastric cancer. However, multivariate analysis demonstrated that only gender and the extent of lymph node dissection were significant variables. Among these variables, gender was an independent prognostic factor for survival only in the T2N1 group. On the other hand, the extent of lymph node dissection was an independent prognostic factor in the T3N0 group, not in the T2N1 group. Conclusions: There was no significant difference in survival between the T2N1 and the T3N0 groups. Thus, our data support the accuracy of the TNM staging classification for stage II gastric cancer. We found a significant survival benefit with D2 dissection for T3N0 but not T2N1. However, before recommending limited lymph node dissection for T2N1 stage disease, development of a preoperative method for prediction of depth of invasion and lymph node status is needed.",
author = "Park, {Joong Min} and Kim, {Jong Han} and Sungsoo Park and Kim, {Seung Joo} and Mok, {Young Jae} and Kim, {Chong Suk}",
year = "2008",
month = "6",
day = "1",
doi = "10.1007/s00268-007-9440-5",
language = "English",
volume = "32",
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TY - JOUR

T1 - Prognostic factors and availability of D2 lymph node dissection for the patients with stage II gastric cancer

T2 - Comparative analysis of subgroups in stage II

AU - Park, Joong Min

AU - Kim, Jong Han

AU - Park, Sungsoo

AU - Kim, Seung Joo

AU - Mok, Young Jae

AU - Kim, Chong Suk

PY - 2008/6/1

Y1 - 2008/6/1

N2 - Background: According to the fifth edition of the UICC TNM classification, stage II gastric cancer has three subgroups: T1N2M0, T2N1M0, and T3N0M0. This study was designed to investigate the prognosis of stage II gastric cancer according to the T and N category to verify the accuracy of TNM staging for stage II and to determine the prognostic factors for patients with stage II gastric cancer by subgroup. Methods: Clinicopathologic data from 326 patients with stage II gastric cancer were studied. We stratified the patients into T2N1 and T3N0 groups and performed comparative analysis between the two groups as well as univariate and multivariate survival analyses for each group. Results: The five-year survival rate for patients with T2N1 disease was 75.6%, whereas for patients with T3N0 disease it was 68.3%. There was no significant difference in survival between T2N1 and T3N0 groups (p = 0.174). Univariate survival analysis showed that age, gender, histological type, and the extent of lymph node dissection were significant prognostic factors for stage II gastric cancer. However, multivariate analysis demonstrated that only gender and the extent of lymph node dissection were significant variables. Among these variables, gender was an independent prognostic factor for survival only in the T2N1 group. On the other hand, the extent of lymph node dissection was an independent prognostic factor in the T3N0 group, not in the T2N1 group. Conclusions: There was no significant difference in survival between the T2N1 and the T3N0 groups. Thus, our data support the accuracy of the TNM staging classification for stage II gastric cancer. We found a significant survival benefit with D2 dissection for T3N0 but not T2N1. However, before recommending limited lymph node dissection for T2N1 stage disease, development of a preoperative method for prediction of depth of invasion and lymph node status is needed.

AB - Background: According to the fifth edition of the UICC TNM classification, stage II gastric cancer has three subgroups: T1N2M0, T2N1M0, and T3N0M0. This study was designed to investigate the prognosis of stage II gastric cancer according to the T and N category to verify the accuracy of TNM staging for stage II and to determine the prognostic factors for patients with stage II gastric cancer by subgroup. Methods: Clinicopathologic data from 326 patients with stage II gastric cancer were studied. We stratified the patients into T2N1 and T3N0 groups and performed comparative analysis between the two groups as well as univariate and multivariate survival analyses for each group. Results: The five-year survival rate for patients with T2N1 disease was 75.6%, whereas for patients with T3N0 disease it was 68.3%. There was no significant difference in survival between T2N1 and T3N0 groups (p = 0.174). Univariate survival analysis showed that age, gender, histological type, and the extent of lymph node dissection were significant prognostic factors for stage II gastric cancer. However, multivariate analysis demonstrated that only gender and the extent of lymph node dissection were significant variables. Among these variables, gender was an independent prognostic factor for survival only in the T2N1 group. On the other hand, the extent of lymph node dissection was an independent prognostic factor in the T3N0 group, not in the T2N1 group. Conclusions: There was no significant difference in survival between the T2N1 and the T3N0 groups. Thus, our data support the accuracy of the TNM staging classification for stage II gastric cancer. We found a significant survival benefit with D2 dissection for T3N0 but not T2N1. However, before recommending limited lymph node dissection for T2N1 stage disease, development of a preoperative method for prediction of depth of invasion and lymph node status is needed.

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U2 - 10.1007/s00268-007-9440-5

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