Positive Lymph Node Ratio As an Indicator of Prognosis and Local Tumor Clearance in N3 Gastric Cancer

Overview

Journal J Gastrointest Surg

Specialty Gastroenterology

Date 2016 Jun 30

PMID 27353383

Citations 23

Authors

Shuhei Komatsu

Daisuke Ichikawa

Mahito Miyamae

Toshiyuki Kosuga

Kazuma Okamoto

Tomohiro Arita

Hirotaka Konishi

Ryo Morimura

Yasutoshi Murayama

Atsushi Shiozaki

Yoshiaki Kuriu

Hisashi Ikoma

Masayoshi Nakanishi

Hitoshi Fujiwara

Eigo Otsuji

Affiliations

Soon will be listed here.

Abstract

Background: Nodal metastasis is an important clinical issue in gastric cancer patients. This study was designed to investigate the clinical usefulness of the positive lymph node ratio (PLNR), which reflects both metastatic and retrieved lymph node numbers, in patients with pN3 gastric cancer.

Methods: We retrospectively analyzed the records of 138 consecutive pN3 patients who underwent curative gastrectomy with lymphadenectomy from 2000 to 2012.

Results: A PLNR of 0.4 was proved to be the best cutoff value to stratify the prognosis of patients with pN3 gastric cancer (P < 0.001). Univariate and multivariate analyses revealed that older age, larger tumor size (≥10 cm), and PLNR ≥ 0.4 [P < 0.001, HR 3.1 (95 % CI 1.7-5.4)] were independent prognostic factors in pN3 gastric cancer. Regarding the recurrence, patients with PLNR <0.4 had a significantly lower rate of lymph node recurrence than those with PLNR ≥0.4 (P = 0.020). There was no significant difference in the lymph node recurrence rate between N3a and N3b patients in the PLNR <0.4 group [P = 0.546, 11.6 % (7/60) vs. 12.5 (1/8)], indicating a better local control regardless of pN3 subgroups.

Conclusions: PLNR is useful to stratify the prognosis and evaluate the extent of local tumor clearance in pN3 gastric cancer.

Citing Articles

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Liu C, Lu J, An L Medicine (Baltimore). 2024; 103(22):e38376.

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Machine learning methods predict recurrence of pN3b gastric cancer after radical resection.

Wang H, Shi J, Yang Y, Ma K, Xue Y Transl Cancer Res. 2024; 13(3):1519-1532.

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Treatment Outcomes and Prognostic Factors in N3 Stage Gastric Cancer After Curative Resection: A Real World Data.

Caliskan Yildirim E, Acikgoz Y, Ergun Y, Algin E, Bal O Cancer Manag Res. 2023; 15:1085-1096.

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Evaluation of the prognostic value of negative to positive lymph node ratio in gastric cancer: results from multi-institutional cohorts from western and eastern datasets - Cohort study.

Wang X, Wang P, Wang W, Sun Z, Wang Z, Zhang R Ann Med Surg (Lond). 2023; 85(6):2348-2355.

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Evaluating prognostic value and stage migration effects using a positive lymph node ratio in adenocarcinoma of the esophagogastric junction.

Kamiya H, Komatsu S, Nishibeppu K, Ohashi T, Konishi H, Shiozaki A BMC Cancer. 2023; 23(1):218.

PMID: 36890486 PMC: 9996992. DOI: 10.1186/s12885-023-10689-6.

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