Prognostic significance of metastatic lymph node ratio in gastric cancer: a Western-center analysis
Abstract Background Tumor-node-metastasis (TNM) staging is the central gastric cancer (GC) staging system, but it has some disadvantages. However, the lymph node ratio (LNR) can be used regardless of the type of lymphadenectomy and is considered an important prognostic factor. This study aimed to ev...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-08-01
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| Series: | BMC Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12893-023-02127-y |
| _version_ | 1797454085828378624 |
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| author | Muhammer Ergenç Tevfik Kıvılcım Uprak Muhammed İkbal Akın Ece Elif Hekimoğlu Çiğdem Ataizi Çelikel Cumhur Yeğen |
| author_facet | Muhammer Ergenç Tevfik Kıvılcım Uprak Muhammed İkbal Akın Ece Elif Hekimoğlu Çiğdem Ataizi Çelikel Cumhur Yeğen |
| author_sort | Muhammer Ergenç |
| collection | DOAJ |
| description | Abstract Background Tumor-node-metastasis (TNM) staging is the central gastric cancer (GC) staging system, but it has some disadvantages. However, the lymph node ratio (LNR) can be used regardless of the type of lymphadenectomy and is considered an important prognostic factor. This study aimed to evaluate the relationship between LNR and survival in patients who underwent curative GC surgery. Methods All patients who underwent radical gastric surgery between January 2014 and June 2022 were retrospectively evaluated. Clinicopathological features of tumors, TNM stage, and survival rates were analyzed. LNR was defined as the ratio between metastatic lymph nodes and total lymph nodes removed. The LNR groups were classified as follows: LNR0 = 0, 0.01 < LNR1 ≤ 0.1, 0.1 < LNR2 ≤ 0.25 and LNR3 > 0.25. Tumor characteristics and overall survival (OS) of the patients were compared between LNR groups. Results After exclusion, 333 patients were analyzed. The mean age was 62 ± 14 years. According to the LNR classification, no difference was found between groups regarding age and sex. However, TNM stage III disease was significantly more common in LNR3 patients. Most patients (43.2%, n = 144) were in the LNR3 group. In terms of tumor characteristics (lymphatic, vascular, and perineural invasion), the LNR3 group had significantly poorer prognostic factors. The Cox regression model defined LNR3, TNM stage II—III disease, and advanced age as independent risk factors for survival. Patients with LNR3 demonstrated the lowest 5-year OS rate (35.7%) (estimated mean survival was 30 ± 1.9 months) compared to LNR 0–1–2. Conclusion Our study showed that a high LNR was significantly associated with poor OS in patients who underwent curative gastrectomy. LNR can be used as an independent prognostic predictor in GC patients. |
| first_indexed | 2024-03-09T15:32:10Z |
| format | Article |
| id | doaj.art-6db45901d3734a9f9dce3a406a6225e6 |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-03-09T15:32:10Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-6db45901d3734a9f9dce3a406a6225e62023-11-26T12:11:44ZengBMCBMC Surgery1471-24822023-08-012311810.1186/s12893-023-02127-yPrognostic significance of metastatic lymph node ratio in gastric cancer: a Western-center analysisMuhammer Ergenç0Tevfik Kıvılcım Uprak1Muhammed İkbal Akın2Ece Elif Hekimoğlu3Çiğdem Ataizi Çelikel4Cumhur Yeğen5Department of General Surgery, Marmara University School of MedicineDepartment of General Surgery, Marmara University School of MedicineDepartment of General Surgery, Marmara University School of MedicineMarmara University School of MedicineDepartment of Pathology, Marmara University School of MedicineDepartment of General Surgery, Marmara University School of MedicineAbstract Background Tumor-node-metastasis (TNM) staging is the central gastric cancer (GC) staging system, but it has some disadvantages. However, the lymph node ratio (LNR) can be used regardless of the type of lymphadenectomy and is considered an important prognostic factor. This study aimed to evaluate the relationship between LNR and survival in patients who underwent curative GC surgery. Methods All patients who underwent radical gastric surgery between January 2014 and June 2022 were retrospectively evaluated. Clinicopathological features of tumors, TNM stage, and survival rates were analyzed. LNR was defined as the ratio between metastatic lymph nodes and total lymph nodes removed. The LNR groups were classified as follows: LNR0 = 0, 0.01 < LNR1 ≤ 0.1, 0.1 < LNR2 ≤ 0.25 and LNR3 > 0.25. Tumor characteristics and overall survival (OS) of the patients were compared between LNR groups. Results After exclusion, 333 patients were analyzed. The mean age was 62 ± 14 years. According to the LNR classification, no difference was found between groups regarding age and sex. However, TNM stage III disease was significantly more common in LNR3 patients. Most patients (43.2%, n = 144) were in the LNR3 group. In terms of tumor characteristics (lymphatic, vascular, and perineural invasion), the LNR3 group had significantly poorer prognostic factors. The Cox regression model defined LNR3, TNM stage II—III disease, and advanced age as independent risk factors for survival. Patients with LNR3 demonstrated the lowest 5-year OS rate (35.7%) (estimated mean survival was 30 ± 1.9 months) compared to LNR 0–1–2. Conclusion Our study showed that a high LNR was significantly associated with poor OS in patients who underwent curative gastrectomy. LNR can be used as an independent prognostic predictor in GC patients.https://doi.org/10.1186/s12893-023-02127-yGastrectomyLymph node ratioMetastatic lymph node ratioSurvivalPrognosis |
| spellingShingle | Muhammer Ergenç Tevfik Kıvılcım Uprak Muhammed İkbal Akın Ece Elif Hekimoğlu Çiğdem Ataizi Çelikel Cumhur Yeğen Prognostic significance of metastatic lymph node ratio in gastric cancer: a Western-center analysis BMC Surgery Gastrectomy Lymph node ratio Metastatic lymph node ratio Survival Prognosis |
| title | Prognostic significance of metastatic lymph node ratio in gastric cancer: a Western-center analysis |
| title_full | Prognostic significance of metastatic lymph node ratio in gastric cancer: a Western-center analysis |
| title_fullStr | Prognostic significance of metastatic lymph node ratio in gastric cancer: a Western-center analysis |
| title_full_unstemmed | Prognostic significance of metastatic lymph node ratio in gastric cancer: a Western-center analysis |
| title_short | Prognostic significance of metastatic lymph node ratio in gastric cancer: a Western-center analysis |
| title_sort | prognostic significance of metastatic lymph node ratio in gastric cancer a western center analysis |
| topic | Gastrectomy Lymph node ratio Metastatic lymph node ratio Survival Prognosis |
| url | https://doi.org/10.1186/s12893-023-02127-y |
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