Abstract: Objective: To evaluate N05.6 group lymph node metastasis, describe the clinicopathological characteristics and prognosis, and analyze factors affecting the prognosis of patients with upper gastric cancer, in order to provide a theoretical basis for the surgical method used to treat patients with upper gastric cancer. Method: Clinicopathological data of 231 patients with upper gastric cancer who were admitted to Anqing Municipal Hospital from September 2010 to June 2015 were analyzed retrospectively. According to postoperative pathologic results, the lymph node metastasis rate of the N05.6 group was calculated. All the patients were followed up via outpatient examination and telephone interview up to June 2018. The count data were analyzed using the chi-square test. The survival curve was drawn using the Kaplan-Meier method. The survival ana1ysis and univariate analysis were performed using the Log-rank test, and multivariate analysis was performed using the Cox regression model. Results : The mean number of dissected lymph nodes was 18.60 (4, 297/231) . The N05.6 group lymph node metastasis rate among the 231 patients was 8.23% (19/231). The N stage and TNM stage in all patients were compared, showing significant differences (χ²=14.219, 13.171; P<0.05). A total of 229 patients were followed up for (4-94) months median, 49 months; follow-up rate: 99.13% (229/231), and the 5-year cumulative survival rate was 70.3%. The median survival time and 5-year cumulative survival rate in patients with positive and negative N05.6 group lymph node were 42 months and 48.6% and, 50 months and 71.9%, respectively, with a significant difference noted in the survival of patients (χ²=6.175, P<0.05). The results of univariate analysis showed that the tumor differentiation, N stage, TNM stage and the N05.6 group lymph node metastasis were factors affecting the prognosis of patients with upper gastric cancer (χ²=4.583, 28.224, 9.136, 6.175; P<0.05). The results of multivariate analysis showed that the N stage was an independent risk factor affecting the prognosis of patients with upper gastric cancer (HR=0.096, 95%CIl: 0.027-0.341, P<0.05). Conclusions : N stage was an independent risk factor affecting the prognosis of patients with upper gastric cancer, therefore, the proximal gastrectomy may be performed in patients with T1 and T2 stage disease with no distant metastasis as therapy for upper gastric cancer.