Results from a study from the National Cancer Data Base (NCDB) found that adequate lymph node staging is critical for appropriate treatment of gastric cancer and that radiotherapy may improve patient outcomes even when lymph node staging is not adequate. Researchers from Penn State University used data from 3008 NCDB patients who underwent gastrectomy for gastric cancer and compared the impact of adjuvant radiotherapy versus chemotherapy alone on survival. Overall, mortality was 29 percent higher after chemotherapy alone than after radiotherapy, according to the study published in the Annals of Surgery. Increased pathologic staging, positive lymph nodes, and inadequate lymph node staging all strongly predicted risk-adjusted mortality. In propensity-matched comparisons, the median survival was significantly higher in 1869 patients treated with radiotherapy than in 669 patients treated with chemotherapy alone (36.1 months versus 28.9 months). And, the 1-year (83.9% versus 74.9%) and 5-year (40.2% versus 31.9%) survival rates were higher in radiotherapy patients than in the chemotherapy-only group.