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

Abstract

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.

Evaluation of the staging systems for gastric cancer

“…Nonetheless, some investigators demonstrated that both the 6th pN and 7th pN classifications were not the most appropriate cutoffs for number of positive nodes to predict the clinical outcomes of GC patients . LNR has been proposed as another promising classification, which was considered to be superior to pN classification in some retrospective studies .…”

Impact of Lymph Node Ratio on the Survival of Patients with Hypopharyngeal Squamous Cell Carcinoma: A Population-Based Analysis

“…The lymph node ratio (LNR), defined as the number of involved nodes divided by the number of lymph nodes examined, was found to improve prognostic information in breast cancer, gastric cancer, colorectal cancer, melanoma and others. [6], [7], [8], [9], [10], [11], [12] Approximately 60% to 80% of patients with hypopharyngeal cancer have locally advanced disease with spread to regional nodes at diagnosis. [13] However, there have been no previous studies on the impact of the LNR on predicting the prognosis of hypopharyngeal cancer.…”

Superiority of the Ratio Between Negative and Positive Lymph Nodes for Predicting the Prognosis for Patients With Gastric Cancer

“…9,10 Recently, we demonstrated that the ratio between negative and positive lymph nodes (R NP ) is associated with prognosis prediction for smallscale patients with positive lymph node metastasis. 11 To test the clinical applicability of R NP for prognostic prediction in GC, we designed this study to elucidate the most accurate prognostic predictor among N stage, R PD , and R NP for large-scale GC patients.…”