Prognostic Significance of Metastatic Lymph Node Ratio in Gastric Cancer

Abstract

Objective: The objective of this study was to analyze the prognostic value of lymph node ratio in patients with gastric cancer. Methods: A total of 22 cases of total and subtotal gastrectomy received in the period of January 2015 to July 2018 in the department of pathology of a tertiary care hospital were assessed. The surgical data and the histopathological findings were assessed using definitive criteria. Pearson's correlation coefficient and chi-square test was used to study the relation between the lymph nodes showing metastasis and the total number of lymph nodes harvested. The relation of LNR with the other clinicopathological parameters was studied. Results: A cut off value of 0.25 was taken and the cases were grouped into low grade and high grade LNR group. In this study we found that the LNR was associated with the number of metastatic lymph nodes, irrespective of the total number of lymph nodes dissected. Hence it could be used as a prognostic indicator even when less number of lymph nodes is retrieved. Conclusions: LNR could be considered as a valuable prognostic factor and could be used as an additional tool with the TNM staging system to assess prognosis in patients post-surgery. It is especially useful in cases where prescribed number of lymph nodes cannot be retrieved.