Macroscopically node‐negative but histologically node‐positive gastric carcinoma

The features of macroscopically node‐negative but histologically node‐positive (N(−) n(+)) tumours were examined in 521 patients undergoing curative surgery for gastric carcinoma. Of 240 histologically node‐positive tumours, 62 (26 per cent) were N(−) n(+). The 10‐year survival rate of patients with N(−) n(+) tumour at 66 per cent was worse than that of those with histologically node‐negative tumour (91 per cent) (P<0.01) but better than that of patients with macroscopically and histologically node‐positive tumour (40 per cent) (P<0.01). N(−) n(+) tumour was characterized by size less than 5 cm (47 per cent), invasion not beyond the muscularis propria (53 per cent), lymph node metastasis limited to group 1 nodes (76 per cent), number of positive nodes fewer than seven (90 per cent) and disease of stage II (52 per cent). The survival of patients with N(−) n(+) tumour was determined by the number of positive nodes and stage of disease. N(−) n(+) tumours are associated with a better outcome, owing to less progressive disease, and the number of positive nodes is a prognostic indicator.