scholarly journals Study of Survival in Gastric Cancer with Emphasis on Lymph Node Status as an Independent Prognostic Factor

2019 ◽  
Vol 4 (4) ◽  
pp. 185-189
Author(s):  
Nicolae Suciu ◽  
Orsolya Bauer ◽  
Zalán Benedek ◽  
Radu Ghenade ◽  
Marius Coroș ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Prognostic Factor ◽  
Lymph Nodes ◽  
Vascular Invasion ◽  
Lymph Node Ratio ◽  
Independent Prognostic Factor ◽  
Lymph Node Status ◽  
Node Ratio ◽  
Gastric Cancer Patients

Abstract Background: Lymph node status in gastric cancer is known as an independent prognostic factor that guides the surgical and oncological treatment and independently influences long-term survival. Several studies suggest that the lymph node ratio has a greater importance in survival than the number of metastatic lymph nodes. Aim: The aim of this study was to evaluate the clinical and morphological factors that can influence the survival of gastric cancer patients, with an emphasis on nodal status and the lymph node ratio. Material and methods: We conducted a retrospective study in which 303 patients with gastric cancer admitted to the Department of Surgery of the Mureș County Hospital between 2008 and 2018 were screened for study enrolment. Data were obtained from the records of the department and from the histopathological reports. The examined variables included: age, gender, tumor localization, T stage, histological type, grade of differentiation, surgical procedure, lympho-vascular invasion, excised lymph nodes, metastatic lymph nodes, lymph node ratio. After screening, the study included a total number of 100 patients, for which follow-up data was available. Results: The mean age of the study population was 66.43 ± 10 years, and 71% were males. The average survival period was 21.42 months. Statistical analysis showed that the localization of the tumor (p = 0.021), vascular invasion (p ---lt---0.001), T (p = 0.004) and N (p ---lt---0.001) stages, type of surgery (partial gastrectomy 59% vs. total gastrectomy 41%, p = 0.005), as well as the lymph node ratio (p ---lt---0.001) were prognostic factors for survival in patients with gastric cancer undergoing surgical therapy. Conclusions: The survival of gastric cancer patients is significantly influenced by tumor localization, T stage, vascular invasion, type of surgery, N stage and the lymph node ratio based on univariate analysis. Also, the lymph node ratio proved to be an independent prognostic factor for survival.

Lymph node ratio and survival for gastric cancer: A retrospective analysis of the SEER database

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 4561-4561
Author(s):  
R. Shridhar ◽  
G. W. Dombi
Keyword(s):  
Gastric Cancer ◽  
Multivariate Analysis ◽  
Lymph Node ◽  
Prognostic Factor ◽  
Lymph Nodes ◽  
Lymph Node Ratio ◽  
Seer Database ◽  
Node Negative ◽  
Node Ratio ◽  
Gastric Cancer Patients

4561 Purpose: To determine the prognostic significance of the lymph node ratio (ratio of number of positive lymph nodes to number of dissected lymph nodes) in gastric cancer patients. Methods: We retrospectively analyzed 10,176 gastric patients from 1990–2003 who underwent curative gastrectomy from the SEER database. Survival curves were calculated according to the Kaplan-Meier method and analyzed with log-rank test. Multivariate analysis of prognostic factors related to survival was performed by the Cox proportional hazard model. Results: The lymph node ratio (LNR) was a strong predictor of survival. LNR was equally predictive of survival whether the analysis was restricted to patients with <15 lymph nodes dissected or >15 lymph nodes dissected. Survival of patients with a LNR of 0.1–5% was not significantly different than node negative patients; however, survival of patients with a LNR of 5–10% was significantly different than node negative patients. Multivariate analysis showed that LNR, T-stage, tumor size, and number of lymph nodes positive were independent prognostic predictors of death and that LNR was the strongest predictor for death. Multivariate analysis showed that the number of lymph nodes dissected was an independent prognostic factor for survival. Moreover, LNR was an independent prognostic factor for N1 and N2 patients by AJCC staging. LNR trended toward significance in AJCC N3 patients. Conclusions: LNR was the strongest predictor of death in gastric cancer patients when compared to T-stage, number of lymph nodes positive, and tumor size. LNR is equally predictive regardless of the adequacy of the lymph node dissection. No significant financial relationships to disclose.

scholarly journals Lymph Node Ratio Predicts Overall Survival in pT4 Gastric Cancer Patients who Underwent Curative Surgery

2021 ◽  
Author(s):  
Fan Yang ◽  
Xinying Yu ◽  
Qi Li ◽  
Jun Wu ◽  
Yang Chen ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Lymph Node ◽  
Prognostic Factor ◽  
Lymph Nodes ◽  
Prognostic Value ◽  
Lymph Node Ratio ◽  
Curative Surgery ◽  
Cutoff Values ◽  
Node Ratio

Abstract Background: Lymph node ratio (LNR), the ratio of metastatic lymph nodes to the total number of examined lymph nodes, has been considered a prognostic factor in gastric cancer (GC) patients. However, the predictive values of LNR vary as characteristics of patients are different. We confirmed its prognostic value and investigated the differences between patients with different pathological features.Methods: Totally, 211 GC patients who underwent curative gastrectomy between October 2004 and November 2016 were retrospectively investigated. Patients were classified into LNR 0, 1 and 2, using cutoff values 0.05 and 0.2. Cutoff values were calculated by Youden index. Relationships between LNR and clinicopathological characteristics were investigated by chi-square test or Fisher's exact test. Survival analysis were based on Cox proportional hazard regression model and Kaplan-Meier method.Results: LNR were related to tumor size (p = 0.003), Lauren classification (p = 0.007), grade of differentiation (p = 0.041), pT stage (p = 0.050) and pN stage (p < 0.001). In multivariable analysis, LNR was an independent prognostic factor (HR = 7.023, p < 0.001). In stratification analysis, LNR showed independent prognostic value (HR = 4.852, p < 0.001) in pT4 patients, but not in pT3 patients (p = 0.361) and pT1-2 patients (p = 0.123). Conclusions: LNR is an independent predictor of overall survival in pT4 GC patients who underwent curative 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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