ABSTRACT
BACKGROUND/AIMS: This study aimed to investigate the role of metastatic lymph node ratio (MLR) in the evaluation of prognosis of patients with gastric cancer at different T stages. METHODOLOGY: Clinical information was reviewed retrospectively in a total 535 patients who underwent surgery for gastric cancer. The prognostic value of MLR was compared with that of pN determined according to the UICC/AJCC guidelines (7th Edition), and the characteristics and advantages of MLR were analyzed. Moreover, the role of MLR in the evaluation of prognosis of patients with gastric cancer at different pT stages was investigated. RESULTS: Univariate Kaplan-Meier method was used for the analysis of survival, and the results showed that MLR was closely associated with the prognosis of these patients. Multivariate analysis with Cox proportional hazards regression model showed that MLR was a major independent risk factor in the prognosis of gastric cancer patients. The area under the ROC curve of MLR in predicting the death of gastric cancer patients within 5 years after surgery was not associated with pN stage. MLR was effective in predicting the prognosis of patients with stage pT2 or pT3 gastric cancer (P < 0.05). CONCLUSIONS: MLR is an independent risk factor in the prognosis of gastric cancer. MLR has a prognostic ability comparable to that of pN stage in gastric cancer. Thus, it is more reliable than pN in the evaluation of prognosis of gastric cancer patients, especially those with stage pT2-pT3 gastric cancer.
Subject(s)
Lymph Nodes/pathology , Stomach Neoplasms/pathology , Adult , Aged , Aged, 80 and over , Area Under Curve , Female , Humans , Kaplan-Meier Estimate , Lymph Nodes/surgery , Lymphatic Metastasis , Male , Middle Aged , Multivariate Analysis , Neoplasm Staging , Predictive Value of Tests , Proportional Hazards Models , ROC Curve , Reproducibility of Results , Retrospective Studies , Risk Factors , Stomach Neoplasms/mortality , Stomach Neoplasms/surgery , Time Factors , Treatment Outcome , Young AdultABSTRACT
BACKGROUND/AIMS: Gastric cancer is a common malignancy with high mortality rate, and surgical resection is the primary treatment. METHODOLOGY: A retrospective analysis of patients who received surgical treatment for primary gastric cancer from January 2006 to December 2010 was performed. Cox univariate and multivariate analyses were performed to determine factors associated with decreased survival. RESULTS: A total of 549 patients were included in the analysis (421 men and 128 women) with a mean age of 59.5 years (range, 21-81 years). Radical resection was performed in 496 patients, including D1 resection in 72 cases (14.5%), D2 resection in 380 cases (76.6%), and D3 resection in 44 cases (8.9%). The follow-up ranged from 3 to 67 months, during which 368 patients were alive or censored and 181 patients died. The overall 6-month and 1-, 3-, and 5-years survival rates were 89.8%, 80.8%, 58.9%, and 49.7% respectively. Multivariate analysis indicated that tumor size > 5 cm, increasing TNM stage, no resection, receiving perioperative blood transfusion, serum albumin <37 g/L, and not receiving postoperative comprehensive treatment (Chinese medicine, chemotherapy, immunotherapy) were associated with decreased survival. CONCLUSIONS: Tumor size, TNM stage, extent of resection, serum albumin level, and comprehensive treatment were important prognostic factors.
