Does lymph node ratio (metastasis/total lymph node count) affect survival and prognosis in gastric cancer?

TOPÇU, Ramazan; Şahiner, İbrahim Tayfun; Kendirci, Murat; Erkent, Murathan; Sezikli, İsmail; TUTAN>, Mehmet Berksun

doi:10.15537/smj.2022.43.2.20210464

Cited by 6 publications

(4 citation statements)

References 30 publications

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“…Although LNM was the direct reason for distant metastases, it reflects the biological selection of more aggressive subpopulations showing close relation with local and/or regional recurrence [ 3 , 4 ]. As demonstrated by many researchers, the presence of LNMs is associated with decreased postoperative survival in gastric cancer [ 5 , 6 ], being the most important prognostic factors [ 7 ]. Because the increased rate of early detection in gastric cancer can lead to an improved prognosis, the concentrations on improving patients' quality of life and utilizing minimally invasive treatments have increased [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Low Expression of miR-491-3p Is Correlated with Lymph Node Metastasis in Gastric Cancer

Luo

2022

Evidence-Based Complementary and Alternative Medicine

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Objective. MiR-491-3p, as a tumor suppressor miRNA, was found decreased in many solid tissues. In this study, we aim to investigate miR-491-3p expression in gastric cancer with or without lymph node metastasis (LNM). Methods. GSE173215 dataset from Gene Expression Omnibus (GEO) was used to measure miRNA expression from tissue samples of gastric cancer patients. Moreover, gastric tumor tissues (non-LNM: n = 78; LNM: n = 68) were obtained to detect the miR-491-3p expression. Receiver operating characteristic (ROC) curve and Kaplan–Meier (KM) survival analysis, as well as Cox regression analysis, were performed to reveal the role of miR-491-3p in diagnosis and prognosis of gastric cancer. Results. According to GSE173215 datasets (t = −11.25, adjust P value = 1.30E-06) and our clinical results (0.390 ± 0.193 vs. 0.562 ± 0.166, P < 0.005 ), the gastric cancer patients with LNM showed lower miR-491-3p expression than those without LNM, demonstrating a high diagnostic efficiency (sensitivity: 74.36%; specificity: 69.12%). In addition, both LNM and low miR-491-3p expression were correlated with the poor prognosis of gastric cancer. Furthermore, the LNM patient with low expression of miR-491-3p had the worse prognosis, but the non-LNM patient with high expression of miR-491-3p had the best prognosis. MiR-491-3p expression (HR = 0.003, 95%CI: 3.35E-04∼0.028) and LNM (HR = 2.326, 95%CI: 1.046∼5.173) were independent risk factors for gastric cancer. Conclusion. Downregulated miR-491-3p expression was found in gastric cancer, being a high diagnostic efficiency and an independent risk factor for gastric cancer, especially in those having LNM.

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Section: Introductionmentioning

confidence: 99%

Low Expression of miR-491-3p Is Correlated with Lymph Node Metastasis in Gastric Cancer

Luo

2022

Evidence-Based Complementary and Alternative Medicine

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“…26 Thus, the CNP group was able to obtain higher numbers of LNs, which is consistent with the results [WMD = 6.67, 95% CI: (3.71-9.62), P < .01] in our meta-analysis. Previous studies 27,28,29 showed that a larger number of LN dissections was associated with better long- term survival of patients with GC. Therefore, CNP-trace-guided radical gastrectomy may have a better prognosis.…”

Section: Discussionmentioning

confidence: 95%

Safety and Efficacy of Carbon Nanoparticle-Labeled Lymph Node Dissection in Radical Resection of Gastric Cancer: A Systematic Review and Meta-Analysis

Zhu

Wang

et al. 2023

Technol Cancer Res Treat

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Objective: In this meta-analysis, we investigated the safety and efficacy of carbon nanoparticle (CNP) trace-guided lymph node (LN) dissection during radical gastrectomy. Methods: Literature on CNP tracing compared with non-CNP tracing in radical gastric cancer (GC) surgery was searched from PubMed, EMBASE (Ovid platform), Web of Science, and the Cochrane Library from the establishment of the library until October 2022. This meta-analysis was performed according to the preferred reporting items for systematic reviews and meta-analysis guidelines. Available data regarding the number of LNs dissected, number of metastatic LNs dissected, other surgical outcomes, and postoperative complications were analyzed in a pooled manner. Stata software (version 12.0) was used for the present meta-analysis. Results: This analysis included 7 studies with a total of 1827 GC patients (551 and 1276 in the CNP and non-CNP groups, respectively). The results of the meta-analysis showed that the CNP group had more intraoperative LNs detected [weighted mean difference (WMD) = 6.67, 95% confidence interval (CI): 3.71–9.62], more LN metastases (WMD = 1.60, 95% CI: 0.09-3.12), and less intraoperative bleeding (WMD = 11.33, 95% CI: 6.30-16.37) than the non-CNP group, all with statistically significant differences ( P < .05). For postoperative complications (odds ratio [OR] = 0.88, 95% CI: 0.52-1.48) and operative time (WMD = −11.60, 95% CI: −40.53-17.34), there was no statistically significant difference between the 2 groups ( P > 0.05). Conclusions: CNP was a significant tracer for the LNs of GC. It increased the number of LNs harvested while reducing intraoperative blood loss, without increasing the operative time or postoperative complications. CNP tracer-guided lymphadenectomy is considered safe and effective for gastrectomy.

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“…However, LNMR values of 100% and 50% may better differentiate prognoses. Previous studies have shown that LNMR has a significant advantage over N staging in predicting the prognosis of GC [ 21 , 22 ]. Moreover, considering that the developed system may be more applicable to evaluating patients after their first diagnosis, we did not include treatment information to guide the selection of treatment plans.…”

Section: Discussionmentioning

confidence: 99%

Novel nomogram to predict the overall survival of postoperative patients with gastric signet

et al. 2023

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Background The TNM staging system cannot accurately predict the prognosis of postoperative gastric signet ring cell carcinoma (GSRC) given its unique biological behavior, epidemiological features, and various prognostic factors. Therefore, a reliable postoperative prognostic evaluation system for GSRC is required. This study aimed to establish a nomogram to predict the overall survival (OS) rate of postoperative patients with GSRC and validate it in the real world. Methods Clinical data of postoperative patients with GSRC from 2002 to 2014 were collected from the Surveillance, Epidemiology, and End Results database and randomly assigned to training and internal validation sets at a 7:3 ratio. The external validation set used data from 124 postoperative patients with GSRC who were admitted to the Affiliated Tumor Hospital of Harbin Medical University between 2002 and 2014. The independent risk factors affecting OS were screened using univariate and multivariate analyses to construct a nomogram. The performance of the model was evaluated using the C-index, receiver operating characteristic curve (ROC), calibration curve, decision analysis (DCA) curve, and adjuvant chemotherapy decision analysis. Results Univariate/multivariate analysis indicated that age, stage, T, M, regional nodes optimized (RNE), and lymph node metastasis rate (LNMR) were independent risk factors affecting prognosis. The C-indices of the training, internal validation, and external validation sets are 0.741, 0.741, and 0.786, respectively. The ROC curves for the first, third, and fifth years in three sets had higher areas under the curves, (training set, 0.782, 0.864, 0.883; internal validation set, 0.781, 0.863, 0.877; external validation set, 0.819, 0.863, 0.835). The calibration curve showed high consistency between the nomogram-predicted 1-, 3-, and 5-year OS and the actual OS in the three queues. The DCA curve indicated that applying the nomogram enhanced the net clinical benefits. The nomogram effectively distinguished patients in each subgroup into high- and low-risk groups. Adjuvant chemotherapy can significantly improve OS in high-risk group (P = 0.034), while the presence or absence of adjuvant chemotherapy in low-risk group has no significant impact on OS (P = 0.192). Conclusions The nomogram can effectively predict the OS of patients with GSRC and may help doctors make personalized prognostic judgments and clinical treatment decisions.

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Does lymph node ratio (metastasis/total lymph node count) affect survival and prognosis in gastric cancer?

Cited by 6 publications

References 30 publications

Low Expression of miR-491-3p Is Correlated with Lymph Node Metastasis in Gastric Cancer

Low Expression of miR-491-3p Is Correlated with Lymph Node Metastasis in Gastric Cancer

Safety and Efficacy of Carbon Nanoparticle-Labeled Lymph Node Dissection in Radical Resection of Gastric Cancer: A Systematic Review and Meta-Analysis

Novel nomogram to predict the overall survival of postoperative patients with gastric signet

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