Lymph Node Ratio-based Staging System Outperforms the Seventh AJCC System for Gastric Cancer

2017 ◽  
Vol 40 (1) ◽  
pp. 35-41 ◽  
Author(s):  
Yueh-Chang Lee ◽  
Po-Jen Yang ◽  
Yuxin Zhong ◽  
Thomas E. Clancy ◽  
Ming-Tsan Lin ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Ratio ◽  
Staging System ◽  
Node Ratio

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

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.

Metastatic Lymph Node Ratio: A New Staging System for Gastric Cancer

2009 ◽  
Vol 33 (10) ◽  
pp. 2106-2111 ◽  
Author(s):  
Roberto Persiani ◽  
Stefano Rausei ◽  
Vincenzo Antonacci ◽  
Alberto Biondi ◽  
Francesco Casella ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Ratio ◽  
Metastatic Lymph Node ◽  
Staging System ◽  
Metastatic Lymph ◽  
Node Ratio

A novel simplified approach to incorporating lymph node ratio into gastric cancer staging.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 24-24
Author(s):  
Sarah B. Fisher ◽  
Malcolm Hart Squires ◽  
Sameer H. Patel ◽  
David A. Kooby ◽  
Kenneth Cardona ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Ratio ◽  
Staging System ◽  
Cancer Staging ◽  
Lymph Node Staging ◽  
Cox Regression Analysis ◽  
Simplified Approach ◽  
Staging Systems ◽  
Node Ratio

24 Background: Previous investigators have reported on the value of lymph node ratio (LNR, defined as the number of positive nodes divided by the total number of nodes assessed) in gastric adenocarcinoma (GAC) staging. Given the complexity of previously proposed staging systems, it has not gained widespread acceptance. The aim of our study was to offer a novel simplified approach to incorporating LNR into gastric cancer staging. Methods: 131 patients who underwent curative intent resection with lymphadenectomy for GAC between 1/00-6/11 were identified. Clinicopathologic factors were assessed. Primary outcome was overall survival (OS). Results: Median age was 64 yrs, 51% were male. Median tumor size was 3.5 cm, 67% were poorly differentiated, 20% had perineural invasion, 31% had lymphovascular invasion, and 6% had a positive margin. Locoregional nodal metastases were present in 59% (n=77, N0: 41%, N1: 18%, N2: 22%, N3a: 14%, N3b: 5%). Median number of lymph nodes (LN) assessed was 15.5. Mean FU was 27.3 mos, median OS was 29.3 mos. Median LNR was 0.4 (.04-1). Patients with LNR ≥0.4 had decreased OS as compared to patients with LNR <0.4 (15.1 vs 41.5 mos, p<0.0001); the survival of patients with LNR <0.4 was similar to that of node negative pts (48 mos, p=0.882). On Cox regression analysis, LNR ≥0.4 was more strongly associated with decreased OS (HR 3.09, 95%CI: 1.81-5.26; p<0.0001) compared to the AJCC 7th edition N stage (HR 1.36, 95%CI: 1.11-1.68; p=0.004). In the subset of patients who were inadequately staged and had <16 nodes examined, a LNR ≥0.4 was associated with reduced survival compared to a LNR <0.4 (17.3 vs 41.5 mos, p=.04). Conclusions: Compared to the current lymph node staging system, a lymph node ratio using 0.4 as the cutoff may more accurately predict survival outcomes. It seems to be particularly useful in patients who have inadequate nodal assessment. This simplified approach to lymph node ratio may be a more valuable staging tool than the current AJCC nodal staging system for gastric cancer and needs to be validated.

Comparison of a Lymph Node Ratio–Based Staging System With the 7th AJCC System for Gastric Cancer

2012 ◽  
Vol 255 (3) ◽  
pp. 478-485 ◽  
Author(s):  
Jiping Wang ◽  
Ping Dang ◽  
Chandrajit P. Raut ◽  
Prakash K. Pandalai ◽  
Ugwuji N. Maduekwe ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Ratio ◽  
Staging System ◽  
Node Ratio

Comparison of Lymphatic System Staging Classifications in Patients with Gastric Cancer

2015 ◽  
Vol 87 (11) ◽  
Author(s):  
Arkadiusz Spychała ◽  
Piotr Nowaczyk ◽  
Dawid Murawa
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Akaike Information Criterion ◽  
Predictive Value ◽  
Lymph Node Ratio ◽  
Lymphatic System ◽  
Linear Trend ◽  
Staging System ◽  
Information Criterion ◽  
Node Ratio

AbstractDespite an observed decrease in the incidence of gastric cancer, it still remains an important clinical problem. It is the fourth most common cancer in the world and the second cause of death in cancer patients. The quality of lymphadenectomy procedure and the number of analysed lymph nodes are both important factors influencing the treatment of the patient.was to compare the lymph node ratio staging system with the 6A group consisting of 493 patients who underwent surgery in 1998–2010 due to gastric cancer was used to compare the staging systems. Following statistical analysis, the following cut-off points were adopted for the lymph node ratio for the purpose of comparison: 0, from 0.05 to 0.3, from 0.3 to 0.5 and over 0.5. Subsequently the homogeneity (using chi-square test for linear trend) and the predictive value of the different classifications (using Akaike information criterion) were assessed in order to compare the lymph node ratio staging system with the 6The lymph node ratio classification has a higher discriminatory value than the TNM classifications (higher linear trend result). What is more, the lymph node ratio classification (LNR) had a lower Akaike information criterion value, which means that it has a higher prognostic value than the other classifications. ROC curves and the area under the curve (AUC) were utilised for the analysis of predictive value of the different classifications in patients with gastric cancer.One may conclude, therefore, that the lymph node ratio staging system is the best classification of the lymphatic system in the presented group of patients.

scholarly journals The evaluation of metastatic lymph node ratio staging system in gastric cancer

2012 ◽  
Vol 16 (3) ◽  
pp. 309-317 ◽  
Author(s):  
Yanbing Zhou ◽  
Jizhun Zhang ◽  
Shougen Cao ◽  
Yu Li
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Ratio ◽  
Metastatic Lymph Node ◽  
Staging System ◽  
Metastatic Lymph ◽  
Node Ratio
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