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Figure 1.

Haematoxylin and eosin staining shows extranodal metastasis (EM) in gastric carcinoma.

Tumor cells are scattered into the resected adipose connective tissue around the stomach distinct from the metastatic lymph node. 1A: Original magnification ×100, arrow indicates the EM. 1B: Original magnification×400.

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Table 1.

Correlation between Extranodal Metastasis and clinicopathological factors in gastric carcinoma patients with potential radical resection.

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Table 2.

Univariate and multivariate survival analysis of clinic-pathologic variables in 1343 cases of gastric carcinoma patients with potential radical resection.

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Figure 2.

Prognostic significance of extranodal metastasis (EM) on overall survival rate of the gastric carcinoma patients underwent curative surgery.

2A: A positive EM was significantly associated with a shorter survival time (P<0.001). 2B: Overall survival curves of gastric carcinoma patients stratified by EM number (0, 1, 2, ≥3), (P<0.001, P = 0.337, P = 0.001, respectively).

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Figure 3.

Comparison of survival curves between EMs and the T, N, M stages.

3A: Overall survival curves showed different outcomes among patients with T4a, EM1 and T4b (P = 0.002 and 0.016, respectively). 3B: Overall survival of patients with EM1 was worse than those of the N2 stage and was comparable to those of the N3 stage (P = 0.039 and 0.437, respectively). 3C: Patients with EM2 had a comparable overall survival with those of the M1 stage (P = 0.896).

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Figure 4.

Comparison of survival curves among 103 cases of stage III patients with EM1 before and after consideration of EM1.

4A: Patients with EM1 had a comparable overall survival curves among each substage when EM1 was ignored (P = 0.991). 4B: Patients with EM1 had a distinguishable overall survival curves among each substage when with the consideration of EM1 as N3 stage (P = 0.023).

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Table 3.

Definitions of T, N and M categories and their impact on the prognostic value of staging.

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