Abstract
BACKGROUND: Whether limited examined lymph node (ELN) number is comparable to recommended ELN number for long-term outcomes remains controversial in elderly gastric cancer (GC) patients. The purpose of this study was to assess the long-term survival between limited ELN number and recommended ELN number in elderly GC patients. METHODS: Elderly GC patients over 75 years old from the Surveillance, Epidemiology, and End Results (SEER) database were retrospectively reviewed. The long-term cancer-specific survival (CSS) and overall survival (OS) were compared between the limited ELN number group (ELN <15, limited group) and recommended ELN number (ELN ≥15, recommended group). RESULTS: In total, 1,521 elderly GC patients were divided into the limited group (793 patients, 52.1%) and recommended group (728 patients, 47.9%). The 1-, 3-, and 5-year CSS in the limited group and recommended group were 76.5% vs. 78.6%, 55.0% vs. 58.5%, 47.8% vs. 50.4%. The 1-, 3-, and 5-year OS in the limited group and recommended group were 70.7% vs. 74.8%, 45.1% vs. 50.7%, 33.7% vs. 39.4%. The Kaplan-Meier survival curve analysis of CSS demonstrated no statistical significance between the two groups (P=0.31). Moreover, the OS was similar between the two groups in the elderly GC patients who underwent total gastrectomy (P=0.16). However, the OS were significant shorter in the limited group in elderly GC patients who underwent proximal and distal gastrectomy (both P<0.001). CONCLUSIONS: Limited ELN number might be sufficient for elderly GC patients with total gastrectomy. Prospective studies with a larger sample size are required to validated these results.