Survival after Gastrectomy in Node-Negative Gastric Cancer: A Review and Meta-Analysis of Prognostic Factors

Yanming Zhou, Feng Yu, Lupeng Wu, Feng Ye, Leilei Zhang, Yumin Li, Yanming Zhou, Feng Yu, Lupeng Wu, Feng Ye, Leilei Zhang, Yumin Li

Abstract

Background: Lymph node metastasis is one of the most important prognostic factors for survival of patients with gastric cancer (GC) after surgical resection. Nevertheless, a considerable number of patients have node-negative disease. We performed the present systematic review to evaluate survival and identify prognostic factors in node-negative GC patients undergoing curative intent resection.

Material and methods: Relevant studies published between January 2000 and January 2015 were identified by searching the PubMed database and reviewed systematically. Summary relative risks (RR) and 95% confidence intervals (95% CI) were estimated using random-effects models.

Results: Thirty observational studies involving 12 504 patients were included in the review. Median 5-year overall survival was 84.3% (range, 53-96.3%). Pooled analysis showed that old age (RR, 1.26; 95%CI, 1.13-1.42), <D2 lymph node dissection (1.28; 1.05-1.55), larger tumor (1.18; 1.10-1.26), serosal invasion (2.03; 1.68-2.44), lymphatic invasion (1.25; 1.00-1.57), vascular invasion (1.67; 1.19-2.34), and lymphovascular invasion (1.93; 1.20-3.10) were significant association with decreased survival.

Conclusions: Surgical resection offers good overall survival for patients with node-negative GC. Tumor-related factors seem to have most prognostic significance.

Figures

Figure 1
Figure 1
Result of the meta-analysis on old age.
Figure 2
Figure 2
Result of the meta-analysis on D1 lymphadenectomy.
Figure 3
Figure 3
Result of the meta-analysis on larger tumor.
Figure 4
Figure 4
Result of the meta-analysis on serosal invasion.
Figure 5
Figure 5
Result of the meta-analysis on vessel invasion.

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Source: PubMed

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