Involvement of three or more lymph nodes predicts poor prognosis in submucosal XXXX .

@entity1 @entity5 @entity1600 @entity3 @entity356
BACKGROUND: Multivariate analyses has shown that the status of @entity1600 and the depth of @entity5 penetration through the gastric wall are the most important prognostic factors in @entity1 with advanced @entity356 after curative operation. A clinicopathological study was carried out to clarify a simple and optimal prognostic indicator for @entity356 . METHODS: Retrospective analyses of 982 @entity1 with @entity356 (562 with mucosal [M] and 420 with submucosal [SM] @entity5 ) treated by gastrectomy with D2 lymph node dissection were performed. RESULTS: The incidence of @entity1600 from M and @entity5 was 2.5% (14/562) and 20.2% (85/420), respectively. There were no apparent prognostic indicators in @entity1 with @entity5 . In @entity1 with @entity5 , the @entity5 -specific 5-year survival of those with @entity1600 was significantly lower than that of those without such @entity3 (77.6% vs 98.2%; P < 0.001). An sharp decrease in survival was seen between @entity1 with two positive nodes and those with three positive nodes, and the @entity5 -specific 5-year survival rate of @entity1 with three or more metastatic lymph nodes was significantly lower than that of those with one or two nodes (P < 0.001; univariate analysis). Multivariate analysis revealed that the involvement of three or more lymph nodes was the sole independent prognostic determinant (P = 0.016); the level of nodal @entity3 was not an independent prognostic factor (P = 0.384). All @entity1 with N2 lymph node echelons (according to the Japanese Research Society for @entity356 classification of the draining lymph nodes of the stomach) in the group with one or two positive nodes survived for more than 5 years. CONCLUSION: The sole independent prognostic factor in SM @entity356 is the involvement of three or more metastatic lymph nodes. We suggest that this simple prognostic indicator for the follow-up of @entity356 , and this could lead to potentially effective adjuvant chemotherapy.
