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

Fukuda, Naoto; Sugiyama, Yasuyuki; Midorikawa, Akira; Mushiake, Hajime

doi:10.1007/s00268-009-0205-1

Cited by 32 publications

(25 citation statements)

References 27 publications

(52 reference statements)

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“…It is known that the site of the tumour, tumour size and tumour stage, in particular lymph node status, are standard prognostic factors in patients with gastric cancer [27]. Every year a number of new prognostic factors associated with tumour biology-so-called biologic prognostic factorsare proposed.…”

Section: Discussionmentioning

confidence: 99%

Hypoxia, tumour-associated macrophages, microvessel density, VEGF and matrix metalloproteinases in human gastric cancer: interaction and impact on survival

et al. 2011

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Section: Discussionmentioning

confidence: 99%

Hypoxia, tumour-associated macrophages, microvessel density, VEGF and matrix metalloproteinases in human gastric cancer: interaction and impact on survival

et al. 2011

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“…In addition, many investigators demonstrated the RPDL was the most intensive category of the nodal metastasis for predication the postoperative OS of gastric cancer patients, owing to its inhibition of the stage migration regardless of the number and the extent of lymph node dissection [28]–[30]. Nevertheless, the prognostic superiority of the RPDL has been still controversial for many years [8].…”

Section: Discussionmentioning

confidence: 99%

Ratio between Negative and Positive Lymph Nodes Is Suitable for Evaluation the Prognosis of Gastric Cancer Patients with Positive Node Metastasis

et al. 2012

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ObjectiveTo date, there is no consensus to evaluate the most appropriate category of the nodal metastasis for precise predication the prognosis of gastric cancer patients with positive node metastasis after curative surgery.MethodsWe retrospectively analyzed the clinicopathologic characteristics and overall survival (OS) of 299 gastric cancer patients with positive node metastasis after curative surgery for evaluation the optimal category of the nodal metastasis.ResultsWith the univariate and multivariate survival analyses, the depth of primary tumor invasion was identified as the independent predicators with the OS of 299 gastric cancer patients with nodal metastasis postoperatively, as were the number of positive lymph nodes (PLNs), the number of negative lymph nodes (NLNs), and the ratio between negative and positive lymph nodes (RNPL). The RNPL was identified to be more suitable for predication the OS of gastric cancer patients with positive node metastasis than the ratio between positive and dissected lymph nodes (RPDL) by using the stratum procedure of survival analysis. Besides, we found both PLNs and NLNs were independently correlated with OS of gastric cancer patients with nodal metastasis when RNPL, instead of RPDL, was controlled in the partial correlation model.ConclusionsRNPL, a new category of the nodal metastasis, was suitable for predication the OS of gastric cancer patients with nodal metastasis after curative resection, as were the PLNs, and NLNs.

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“…Fukuda et al [20] compared the pN category of the UICC/TNM in 1997 with a classification based on the metastatic lymph node ratio in patients who underwent R0 resection using the regression analysis, and identified that the metastatic lymph node ratio is the most important prognostic factor for gastric cancer. The results of univariable and multivariable analyses of potential prognostic factors in this study showed that the rN category was one of the independent prognostic parameters.…”

Section: Discussionmentioning

confidence: 99%

Prognostic impact of metastatic lymph node ratio on gastric cancer after curative distal gastrectomy

Huang

Lin²,

Zheng³

et al. 2010

WJG

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AIM:To investigate the prognostic impact of metastatic lymph node ratio (rN) on gastric cancer after curative distal gastrectomy. METHODS:A total of 634 gastric cancer patients who underwent curative resection (R0) of lymph nodes at distal gastrectomy in [1995][1996][1997][1998][1999][2000][2001][2002][2003][2004]. Correlations between positive nodes and retrieved nodes, between rN and retrieved nodes, and between rN and negative lymph node (LN) count were analyzed respectively. Prognostic factors were identified by univariate and multivariate analyses. Staging accuracy of the pN category (5th UICC/TNM system) and the rN category was compared according to the survival rates of patients. A linear regression model was used to identify the relation between rN and 5-year survival rate of the patients. RESULTS:The number of dissected LNs was related with metastatic LNs but not related with rN. Cox regression analysis showed that depth of invasion, pN and rN category were the independent predictors of survival (P < 0.05). There was a significant difference in survival between LN stages classified by the rN category or by the pN category (P < 0.05). However, no significant difference was found in survival rate between LN stages classified by the pN category or by the rN category (P > 0.05). Linear regression model showed a significant linear correlation between rN and the 5-year survival rate of gastric cancer patients (β = 0.862, P < 0.001). Pearson's correlation test revealed that negative LN count was negatively correlated with rN (P < 0.001).CONCLUSION: rN category is a better prognostic tool than the 5th UICC pN category for gastric cancer patients after curative distal gastrectomy. Increased negative LN count can reduce rN and improve the survival rate of gastric cancer patients. Huang CM, Lin JX, Zheng CH, Li P, Xie JW, Lin BJ, Wang JB. Prognostic impact of metastatic lymph node ratio on gastric cancer after curative distal gastrectomy.

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

Abstract: The MLR is an important and easy-to-assess prognostic factor that should be considered for staging lymph node metastasis in patients with gastric cancer.

Cited by 32 publications

References 27 publications

Hypoxia, tumour-associated macrophages, microvessel density, VEGF and matrix metalloproteinases in human gastric cancer: interaction and impact on survival

Hypoxia, tumour-associated macrophages, microvessel density, VEGF and matrix metalloproteinases in human gastric cancer: interaction and impact on survival

Ratio between Negative and Positive Lymph Nodes Is Suitable for Evaluation the Prognosis of Gastric Cancer Patients with Positive Node Metastasis

Prognostic impact of metastatic lymph node ratio on gastric cancer after curative distal gastrectomy

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