Purpose: The presence or absence of lymph node metastasis is significantly associated with the survival of patients with gastric carcinoma. We compared node-positive and node-negative mucosal gastric carcinoma patients to identif y the clinicopathological characteristics of node-positive mucosal gastric carcinoma. We also evaluated the variables associated with lymph node metastasis and survival in this group of patients. Methods: Of the 580 mucosal gastric carcinoma patients, 32 (5.5%) were node-positive. A statistical analysis using the Cox model was performed to determine the factors that can predict the patients' outcomes. Results: The mean tumor size was significantly larger in the patients with node-positive mucosal gastric carcinoma than that in the node-negative patients (3.3 vs. 1.8 cm; P＜0.001). The overall survival rate was lower for the patients who were node-positive than for the patients who were node-negative (83.3% vs. 91.4%, respectively), but the difference was not significant (P＞0.05). Using the Cox proportional hazard regression model, tumor size was an independent statistically significant parameter associated with lymph node metastasis (risk ratio: 4.70, 95% confidence interval: 1.20 to 18.35; P＜0.05). Conclusion: Tumor size is the most reliable predictor of lymph node metastasis for patients with node-positive mucosal gastric carcinoma. Nevertheless, a large tumor size is not associated with a poor outcome for patients with node-positive mucosal gastric carcinoma. The patients with node-positive mucosal gastric carcinoma showed good survival rates after undergoing gastrectomy and extensive node dissection.
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