Abstract
AIM: To investigate the prognostic significance of lymph node micrometastasis (LNMM) in patients with gastric carcinoma. METHODS: Two reviewers independently searched electronic databases including PubMed, EMBASE, the Cochrane Database of Systematic Reviews, the Cochrane Controlled Studies Register, and the China National Knowledge Infrastructure electronic database between January 1996 and January 2014. Strict literature retrieval and data extraction were performed to extract relevant data. Data analysis was conducted using RevMan 5.2.4 software, and relative risks (RRs) for patient death in five years and recurrence were calculated. A fixed- or random-effects model was selected to pool and a forest plot was used to display RRs. RESULTS: Twelve cohort studies containing a total of 1684 patients were identified. LNMM positivity was worse than LNMM negativity with regards to the number of patients who died in five years. The effects of LNMM positivity in patients with gastric cancer of different T-stages remain unclear. LNMM in patients with gastric carcinoma was also associated with a higher recurrence rate. With regards to the number of patients who died in five years, Asian patients were worse than European and Australian patients. CONCLUSION: We recommend that LNMM should not be used as a gold standard for prognosis evaluation in patients with gastric cancer in clinical settings until more high quality trials are available.