The aim of this study is to clarify the prognostic factors in advanced gastric cancer, with special reference to the lymph node metastasis. It is a retrospective study using 401 cases of stage III and IV gastric cancer operated on during five
years
from
July, 1988 to June, 1993. There was a significant difference in the five-year cumulative survival rate according to the N1 or N2 in AJCC-TNM staging, the ratio of the metastatic lymph node to total dissected lymph nodes, and the number of the
metastatic
lymph nodes. In patients of the same clinical stage, the five-year survival rate decreased as the number of the metastatic lymph node and the ratio of the metastatic lymph node to total dissected lymph node increased. The multivariate survival
analysis
using Cox's proportional hazard model was applied to the above mentioned three forms of lymph node status. Among these three variables, the ratio of the metastatic lymph node to total dissected lymph node was the most meaningful prognostic
factor.
A
multivariate survival analysis using Cox's proportional hazard model was performed using the following seven variables: involvement of regional lymph node in AJCC-TNM staging, distant metastasis, ratio of the metastatic lymph node to total
dissected
lymph nodes, number of the metastatic lymph nodes, Borrmann's type, type of operation and adjuvant chemotherapy. Among these variables, the two most important prognostic factors were the ratio of the metastatic lymph node to total dissected lymph
node
and Borrmann's type. (Korean J Gastroenterol 1994 ; 26 : 777-788)
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