The Survival of Gastric Cancer Patients Is Affected by the Number of Lymph Nodes Removed: Focus on Numbers of Lymph Node Retrieved Less Than 15

Gastric cancer is one of the most common causes of cancer death in Taiwan. Lymph node (LN) removal has been an important component in surgical treatment of gastric cancer. However, the relationship between the metastatic to examined lymph nodes and overall survival in stage III gastric cancer patients is worth investigation, especially on numbers of retrieved lymph nodes less than 15. We retrospectively reviewed the records of 64 patients with adenocarcinoma of the stomach who had undergone gastrectomy with curative intent between 2009 and 2012. All the patients received surgical intervention. Patients were divided into two groups: group I patients had ＜ 15 (n = 38) and group II patients had ≥ 15 (n = 26) LN reported. The two groups were similar in age, gender distribution, tumor locations and pathological grading. The median survival was 22.1 and 42 months for groups I and II, respectively. In stage III patients, median survival was 21.8 months for group I and 36 months for group II (P = 0.04). Group II patients also had more proximal lesions (P = 0.02) and a decreased positive to removed LN ratio (P = 0.03). For stage III disease, removal of ≥ 15 LN appears to contribute to a considerable survival. For patients with stage III gastric cancer, lymph node removed might be considered as a crucial prognostic factor. Especially, while the number of retrieved nodes is under 15, we suggest recommend in curative resections of gastric cancer.