Prognostic impact of positive lymph node ratio in gastric carcinoma

J Surg Oncol. 2007 Aug 1;96(2):95-101. doi: 10.1002/jso.20797.

Abstract

Background and objectives: To evaluate the prognostic value of metastatic lymph node ratio in gastric carcinoma.

Methods: One hundred and sixty four patients who underwent D(2) dissection for gastric carcinoma at Ankara Oncology Hospital were reviewed retrospectively. The prognostic factors including Japanese classification, AJCC/UICC TNM classification and metastatic lymph node ratio (1-10% and >10%) were evaluated in univariate and multivariate Cox regression analysis.

Results: The multivariate analysis showed that Borrmann classification, pN-category of AJCC/UICC classification and metastatic lymph node ratio were the most significant prognostic factors and a higher hazard ratio was obtained for metastatic lymph node ratio than pN category of AJCC/UICC classification (4.5 vs. 11.4). When the metastatic ratio groups of 1-10% and >10% were subdivided into pN(1), pN(2) and pN(3) categories of the AJCC/UICC classification, there was no statistical difference between survival curves. When pN(1), pN(2) and pN(3) categories of the AJCC/UICC classification were subdivided into the ratio groups of 1-10% and >10%, the survival rate of ratio group 1-10% was better than ratio group >10%.

Conclusion: With its simplicity and reproducibility, metastatic lymph node ratio can be used as a reliable prognostic indicator.

MeSH terms

  • Adult
  • Aged
  • Female
  • Gastrectomy
  • Humans
  • Lymph Nodes / pathology*
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Stomach Neoplasms / mortality*
  • Stomach Neoplasms / pathology*
  • Stomach Neoplasms / surgery
  • Survival Rate