Prognostic Value of Tumor Size in Node-Negative Gastric Cancer with Adequate Lymph Node Dissection

Stage is the most important variable for gastric adenocarcinoma patients’ survival. Analysis based on TNM classification may limit determination of prognosis in lymph node-negative gastric adenocarcinoma patients. We aimed to examine the role of tumor size in determining overall survival in patients without lymph node metastasis. A total of 183 patients underwent gastrectomy at our hospital’s general surgery clinic between 2013 and 2019. Cases with distant metastasis or lymph node metastasis, those who received neoadjuvant treatment, those with inadequate lymphadenectomy were excluded. Larger tumors (p = 0.011), ASA4 (American Society of Anesthesiology) patients (p = 0.04), patients with perineural invasion (pnı) (p = 0.019) and lymphovascular invasion (LVI) (p = 0.008) were more prevalent in the group experiencing mortality. Patients with higher tumor size than 5 cm showed lower overall survival. Tumor size (p < 0.001), PNI (p = 0.021), LVI (p = 0.009), and differentation (p < 0.001) were specific and subjected to multivariant analysis. Tumors bigger than 5 cm (OR: 3.601 [1.608–8.068], p < 0.001) were related lower overall survival with node-negative gastric adenocarcinoma while well differentation improves (OR: 0.353 [0.170–0.732] p = 0.005). In our study, including patients with adequate lymph node sampling we demonstrated that tumor size is an important prognostic indicator in gastric adenocarcinomas without lymph node involvement in standard gastrectomy.