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

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.

scholarly journals Results of Treatment of Locally advanced Gastric Cancer in the Elderly Patients

2012 ◽  
Vol 23 ◽  
pp. ix229
Author(s):  
D. Egamberdiev ◽  
M. Djuraev ◽  
S. Khudayorov ◽  
O. Nematov ◽  
A. Babaev ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Elderly Patients ◽  
Advanced Gastric Cancer ◽  
Locally Advanced ◽  
The Elderly ◽  
Results Of Treatment ◽  
Locally Advanced Gastric Cancer

Use of lymph node ratio improves staging and selection criteria for adjuvant therapy of gastric cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 4051-4051 ◽  
Author(s):  
N. G. Coburn ◽  
C. J. Swallow ◽  
A. Kiss ◽  
C. Law
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Adjuvant Therapy ◽  
Lymph Node Ratio ◽  
North American Population ◽  
Cox Models ◽  
Node Negative ◽  
Survival Difference ◽  
Node Ratio ◽  
Resected Gastric Cancer

4051 Background: Despite 1997 American Joint Commission on Cancer (AJCC) guidelines stipulating assessment of ≥15 lymph nodes (LN) for staging of gastric cancer, only one third of patients in the Surveillance, Epidemiology and End Results (SEER) database from 1998–2002 had ≥15 LN assessed (ASCO 2005 #4004), with resultant understaging and probable under-treatment. In series from Asia and Europe, Lymph Node Ratio (LNR), the ratio of positive to total LN assessed, has been shown to be more accurate for staging than number of positive LN. However, most of these excluded cases with <15 LN assessed. We examined the utility of LNR in a North American population. Methods: Using SEER data, we identified 9503 M0 resected gastric cancer cases from 1988–2002. LNR was categorized as 0%, 1–10%, 11–30%, 31–50% and >50%. For node negative cases (LNR = 0%, n = 3652), we stratified by number of LN assessed (A=1–4; B = 5–9; C = 10–14; D≥15). For each AJCC stage or LNR strata, the degree of understaging in patients with inadequate LN assessment was measured by survival difference on Kaplan-Meier curves. Cox proportional hazard ratio (HR) models determined the effect of stratifying node negative patients and the accuracy of LNR for prognostication. Results: 27% of patients had a LNR > 50%, a high proportion compared to Asian series. Fewer nodes assessed resulted in a higher likelihood of being node negative. In node negative cases, the HR of death increased for those with fewer LN assessed (vs. Group D, with 95% CI): A: HR=1.6 (1.5–1.8); B: HR = 1.3 (1.1–1.5); C: HR = 1.3 (1.1–1.5). Understaging was observed for patients with inadequate LN assessment when AJCC criteria were used (p < 0.0001); this effect significantly decreased by using LNR. LNR had superior prognostic accuracy in Cox models. Conclusions: This study examines LNR in the largest series of resected gastric cancer in the literature, and the only one in which the majority of cases were inadequately staged. LNR significantly decreases understaging and improves prognostic ability. Node negative patients, nearly one third of cases, should be risk stratified by number of LN assessed, and considered for adjuvant therapy on this basis. LNR should be used to stratify node positive patients in clinical trials, and to provide more accurate staging and prognostication. No significant financial relationships to disclose.

scholarly journals A Novel Approach for Gastric Cancer Staging in Elderly Patients Based on the Lymph Node Ratio

2021 ◽  
Vol 21 (1) ◽  
pp. 84 ◽  
Author(s):  
Joonseon Park ◽  
Chul Hyo Jeon ◽  
So Jung Kim ◽  
Ho Seok Seo ◽  
Kyo Young Song ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Elderly Patients ◽  
Lymph Node Ratio ◽  
Cancer Staging ◽  
Novel Approach ◽  
Node Ratio

scholarly journals Prognostic impact of metastatic lymph node ratio in advanced gastric cancer from cardia and fundus

2008 ◽  
Vol 14 (27) ◽  
pp. 4383 ◽  
Author(s):  
Chang-Ming Huang ◽  
Bi-Juan Lin ◽  
Hui-Shan Lu ◽  
Xiang-Fu Zhang ◽  
Ping Li ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Advanced Gastric Cancer ◽  
Lymph Node Ratio ◽  
Metastatic Lymph Node ◽  
Prognostic Impact ◽  
Metastatic Lymph ◽  
Node Ratio

scholarly journals Outcomes of Distal Gastrectomy for Elderly Patients With Advanced Gastric Cancer: Comparison With Non-Elderly Patients and the Utility of Laparoscopic Distal Gastrectomy for Elderly Patients

2021 ◽  
Vol 105 (1-3) ◽  
pp. 679-687
Author(s):  
Ayako Shimada ◽  
Satoru Ishii ◽  
Hiroto Tanaka ◽  
Tomomi Okamoto ◽  
Kohei Mishima ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Elderly Patients ◽  
Advanced Gastric Cancer ◽  
Surgical Outcomes ◽  
Distal Gastrectomy ◽  
The Elderly ◽  
Node Dissection ◽  
D2 Lymph Node Dissection ◽  
Significant Difference

Background As the elderly population increases, cases of elderly advanced gastric cancer (AGC) also increase. This study aims to investigate the safety and utility of curative gastrectomy, as well as the efficacy of laparoscopic gastrectomy, for these elderly patients. Methods We retrospectively analyzed the surgical outcomes of patients with cStage IB-III AGC who underwent distal gastrectomy (DG) with D2 lymph node dissection in our institution. We compared the results between elderly patients (&gt;75 years) and non-elderly patients (&lt;75 years). We further divided the elderly patients into 2 groups: those who underwent laparoscopic DG (LDG) and those who underwent open DG (ODG). Further, we compared the results of the 2 groups. Results From January 2014 to March 2019, 84 patients underwent DG with D2 lymph node dissection for cStage IB-III AGC (52 elderly patients and 32 non-elderly patients). ASA was significantly higher in elderly patients; however, there was no significant difference in surgical outcomes nor in overall survival (OS) and recurrence-free survival (RFS) between the 2 groups. Among 52 elderly patients, 19 had LDG, whereas 33 had ODG. The LDG group had a significantly shorter length of hospital stay and a significantly less amount of blood loss. There was no significant difference in RFS and OS between these 2 groups. Conclusions Safety and oncologic curability may be achieved in elderly patients with AGC. LDG may be safely performed as ODG in elderly patients with AGC and it is expected to benefit them by achieving minimally invasive surgery.

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.

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