Prognostic value of extracapsular lymph node involvement among patients with gastric cancer

Extracapsular lymph node involvement has a negative prognosis in malignant tumors. To assess the prognostic importance of extracapsular lymph node involvement in patients with gastric cancer with lymph node metastases. Clinical and morphological features and survival of patients with gastric cancer and lymph node involvement operated between 1986 and 2003, were analyzed. Patients with and without extracapsular involvement were compared. During the study period, 459 gastrectomies were performed, 312 patients (68%) had lymph node involvement and 144 (31%) had extracapsular involvement. Patients with and without extracapsular involvement were followed for a median of 10 (range 1 to 120) and 41 (range 1 to 193) months, respectively. Five years actuarial survival for patients with and without extracapsular involvement was 23 and 40% respectively. Extracapsular lymph node involvement and level of wall infiltration were identified as prognostic factors using a multivariate analysis. Extracapsular lymph node involvement is an independent risk factor for mortality among patients with gastric cancer.