# The impact of the number of lymph nodes removed with D2 lymph node dissection on survival in gastric cancer

## TL;DR

This study finds that removing more lymph nodes during gastric cancer surgery improves patient survival rates.

## Contribution

The study identifies a specific threshold of lymph nodes removed that significantly correlates with improved survival in gastric cancer patients.

## Key findings

- A higher number of removed lymph nodes is positively correlated with better survival (p=0.006).
- Patients with fewer than 35 lymph nodes removed had 3.3 times lower survival at 1 year.
- Lymphovascular invasion reduces survival by 4.6 times at 1 year.

## Abstract

The relationship between the number of lymph nodes removed and survival was investigated in patients undergoing radical gastrectomy and D2 lymph node dissection for gastric cancer.

Patients who underwent gastrectomy and D2 lymph node dissection were analyzed. The cases were evaluated based on age, sex, tumor stage, number of removed lymph nodes, operation duration, presence of comorbidities, tumor status at the surgical margin, lymphovascular invasion, and perineural invasion. Survival analyses at 1 and 3 years were conducted.

The 1-year survival rate was 73%, and the 3-year survival rate was 40.4%. Factors associated with 1-year survival included age ≥70 years, the number of removed lymph nodes <35, and the presence of lymphovascular invasion, which negatively impacted survival. Age ≥70 years reduced survival by 3.7 times, the number of lymph nodes removed <35 reduced survival by 3.3 times, and the presence of lymphovascular invasion reduced survival by 4.6 times. For 3-year survival, age affected survival by 4.1 times, and tumor presence at the surgical margin affected survival by 2.85 times. A positive correlation was found between the number of removed lymph nodes and survival (p=0.006).

Lymph node dissection should be performed according to guidelines, and efforts should be made to increase the number of removed lymph nodes.