The association of the lymph node ratio and serum carbohydrate antigen 19-9 with early recurrence after curative gastrectomy for gastric cancer

Abstract Background: The aim of this study was to examine the prognostic value of Metastatic lymph node ratio (MLNR) in patients with gastric cancer (GC) after curative gastrectomy and the potential for new indicators to strengthen the current guidelines.Methods:We retrospectively examined 3864 patients with GC who underwent curative gastrectomy between February 2011 and February 2016. Patients were classified into low-MLNR (L-MLNR), and high-MLNR (H-MLNR) groups according to adjusted X-tile cutoff-value of 0.25 for MLNR, and their clinicopathological characteristics and survival rates were compared.Results: Survival analysis indicated that MLNR was negatively associated with overall survival (OS) (P<0.001) and was an independent prognostic predictor in 3864 GC patients (P<0.001). Stratum analysis and univariate COX proportional hazards analysis were performed to validate the prognostic value of MLNR in various subgroups with clinicopathological characteristics (gender, age at surgery, tumor location, tumor size, type of gastrectomy, T stage, N stage, ELN, perineural invasion, vascular invasion, and TNM stage). MLNR is a prognostic indicator for patients with GC, regardless whether the number of lymph nodes examined is <16 or ≥16.Conclusions:The MLNR may become a new indicator for evaluating prognosis of patients with curative gastrectomy and complement the current guidelines.

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Prognostic significance of positive lymph node ratio in patients with pN3 gastric cancer who underwent curative gastrectomy

Annals of Oncology ◽

10.1093/annonc/mdx261.081 ◽

2017 ◽

Vol 28 ◽

pp. iii35-iii36

Author(s):

Ahmet Bilici ◽

Mesut Seker ◽

Basak Oven Ustaalioglu Bala ◽

Fatih Olmez Omer ◽

Ozcan Yildiz ◽

...

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Lymph Node Ratio ◽

Prognostic Significance ◽

Positive Lymph Node ◽

Curative Gastrectomy ◽

Node Ratio

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Positive lymph node ratio is an index in predicting prognosis for remnant gastric cancer with insufficient retrieved lymph node in R0 resection

Scientific Reports ◽

10.1038/s41598-021-81663-0 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Honghu Wang ◽

Hao Qi ◽

Xiaofang Liu ◽

Ziming Gao ◽

Iko Hidasa ◽

...

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Lymph Nodes ◽

Lymph Node Ratio ◽

Prognostic Index ◽

Staging System ◽

R0 Resection ◽

Remnant Gastric Cancer ◽

Curative Intent ◽

Node Ratio

AbstractThe staging system of remnant gastric cancer (RGC) has not yet been established, with the current staging being based on the guidelines for primary gastric cancer. Often, surgeries for RGC fail to achieve the > 15 lymph nodes needed for TNM staging. Compared with the pN staging system, lymph node ratio (NR) may be more accurate for RGC staging and prognosis prediction. We retrospectively analyzed the data of 208 patients who underwent R0 gastrectomy with curative intent and who have ≤ 15 retrieved lymph nodes (RLNs) for RGC between 2000 and 2014. The patients were divided into four groups on the basis of the NR cutoffs: rN0: 0; rN1: > 0 and ≤ 1/6; rN2: > 1/6 and ≤ 1/2; and rN3: > 1/2. The 5-year overall survival (OS) rates for rN0, rN1, rN2, and rN3 were 84.3%, 64.7%, 31.5%, and 12.7%, respectively. Multivariable analyses revealed that tumor size (p = 0.005), lymphovascular invasion (p = 0.023), and NR (p < 0.001), but not pN stage (p = 0.682), were independent factors for OS. When the RLN count is ≤ 15, the NR is superior to pN as an important and independent prognostic index of RGC, thus predicting the prognosis of RGC patients more accurately.

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Lymph node ratio as a novel and simple prognostic factor in advanced gastric cancer

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2016.03.001 ◽

2016 ◽

Vol 42 (9) ◽

pp. 1253-1260 ◽

Cited By ~ 25

Author(s):

K. Yamashita ◽

K. Hosoda ◽

A. Ema ◽

M. Watanabe

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Prognostic Factor ◽

Advanced Gastric Cancer ◽

Lymph Node Ratio ◽

Node Ratio

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Prognostic significance of the metastatic lymph node ratio compared to the TNM classification in stage III gastric cancer

Nigerian Journal of Clinical Practice ◽

10.4103/njcp.njcp_345_20 ◽

2021 ◽

Vol 24 (11) ◽

pp. 1602

Author(s):

S Gulmez ◽

AS Senger ◽

O Uzun ◽

S Omeroglu ◽

C Ofluoglu ◽

...

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Lymph Node Ratio ◽

Metastatic Lymph Node ◽

Tnm Classification ◽

Prognostic Significance ◽

Stage Iii ◽

Metastatic Lymph ◽

Node Ratio

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Prognostic Significance of the Metastatic Lymph Node Ratio in Gastric Cancer Patients

World Journal of Surgery ◽

10.1007/s00268-009-0205-1 ◽

2009 ◽

Vol 33 (11) ◽

pp. 2378-2382 ◽

Cited By ~ 25

Author(s):

Naoto Fukuda ◽

Yasuyuki Sugiyama ◽

Akira Midorikawa ◽

Hiroyuki Mushiake

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Cancer Patients ◽

Lymph Node Ratio ◽

Metastatic Lymph Node ◽

Prognostic Significance ◽

Metastatic Lymph ◽

Node Ratio ◽

Gastric Cancer Patients

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Survival Based On The Pathologic Lymph Node Ratio For Local Advanced Gastric Cancer; Elderly Patients Versus Non Elderly Patients

10.21203/rs.3.rs-1176546/v1 ◽

2021 ◽

Author(s):

Omer Yalkin ◽

Nidal Iflazoglu ◽

Olgun Deniz ◽

Mustafa Yener Uzunoglu ◽

Ezgi Isil Turhan

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Elderly Patients ◽

Advanced Gastric Cancer ◽

Lymph Node Ratio ◽

Locally Advanced ◽

Survival Rates ◽

The Elderly ◽

Survival Difference ◽

Node Ratio

Abstract Objective: The aim of this study was to clarify the prognostic value of the pathological lymph node ratio for elderly and non-elderly gastric cancer patients and to evaluate whether there is a difference in the survival of patients with the same LNR (Lymph Node Ratio).Materials and Methods: A total of 222 patients diagnosed with locally advanced gastric cancer and who underwent gastrectomy were included. The patients were divided into two groups according to age. Clinicopathological properties of the two groups were compared. Potential prognostic factors affecting survival were analyzed. Subsequently, the effect of lymphadenectomy and LNR on survival in both groups was evaluated. Results: Significant differences were detected in terms of the location of primary lesions, hemoglobin and albumin levels between elderly patients and non-elderly patients (p < .05). Overall survival (OS) was significantly worse in elderly patients (22 months vs. 67 months, p<0.001). The survival rates in elderly patients were significantly lower from those of non-elderly in the subgroup LNR Stage 2 (12.1% vs. 47.9 %, P = 0.004) and LNR Stage 3 classification (9.1% vs. 34.1%, P = 0.039). LNR was found to be significant for OS with a cut-off point of 0.18. Conclusion: A survival difference was found between the elderly and non-elderly patients with the same LNR. LNR was found to be an independent factor for survival especially in elderly patients. Survival was found to be further decreased in elderly patients compared to non-elderly patients with increasing LNR.

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