The prognostic value of N-ratio in patients with gastric cancer: Validation in a large, multicenter series

Marchet, Alberto; Mocellin, Simone; Ambrosi, Alessandro; Manzoni, Giovanni De; Leo, Alberto Di; Marrelli, Daniele; Roviello, Franco; Morgagni, Paolo; Saragoni, Luca; Natalini, G; Santis, Francesco De; Baiocchi, Gian Luca; Coniglio, Arianna; Nitti, Donato

doi:10.1016/j.ejso.2007.04.018

Cited by 106 publications

(79 citation statements)

References 26 publications

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“…A study from Italy [11] showed that the number of metastatic lymph nodes is significantly related with rN, and that the more the number of metastatic lymph nodes is, the higher the rN will be, indicating that gastric cancer patients with a higher rN have a greater risk of death after surgery and a shorter survival time. In this study, when the rN was increased 10%, the calculated 5-year survival rate was decreased by 8.14%, whereas when the rN was decreased 10%, the calculated 5-year survival rate was increased by 8.14%, suggesting that the long-term survival can be improved by reducing rN.…”

Section: Discussionmentioning

confidence: 99%

“…Compared with total gastrectomy, distal gastrectomy is one of the most important operative procedures for gastric cancer, which can decrease postoperative morbidity and mortality and improve the postoperative life quality and nutrition condition of gastric cancer patients [5][6][7][8] . Although there are some studies on the prognostic significance of rN in gastric cancer [9][10][11] , few relevant researches are available on gastric cancer after curative distal gastrectomy. Therefore, the aim of this retrospective study was to evaluate the prognostic value of metastatic lymph node ratio (rN) for gastric cancer after curative distal gastrectomy.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic impact of metastatic lymph node ratio on gastric cancer after curative distal gastrectomy

Huang

Lin²,

Zheng³

et al. 2010

WJG

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AIM:To investigate the prognostic impact of metastatic lymph node ratio (rN) on gastric cancer after curative distal gastrectomy. METHODS:A total of 634 gastric cancer patients who underwent curative resection (R0) of lymph nodes at distal gastrectomy in [1995][1996][1997][1998][1999][2000][2001][2002][2003][2004]. Correlations between positive nodes and retrieved nodes, between rN and retrieved nodes, and between rN and negative lymph node (LN) count were analyzed respectively. Prognostic factors were identified by univariate and multivariate analyses. Staging accuracy of the pN category (5th UICC/TNM system) and the rN category was compared according to the survival rates of patients. A linear regression model was used to identify the relation between rN and 5-year survival rate of the patients. RESULTS:The number of dissected LNs was related with metastatic LNs but not related with rN. Cox regression analysis showed that depth of invasion, pN and rN category were the independent predictors of survival (P < 0.05). There was a significant difference in survival between LN stages classified by the rN category or by the pN category (P < 0.05). However, no significant difference was found in survival rate between LN stages classified by the pN category or by the rN category (P > 0.05). Linear regression model showed a significant linear correlation between rN and the 5-year survival rate of gastric cancer patients (β = 0.862, P < 0.001). Pearson's correlation test revealed that negative LN count was negatively correlated with rN (P < 0.001).CONCLUSION: rN category is a better prognostic tool than the 5th UICC pN category for gastric cancer patients after curative distal gastrectomy. Increased negative LN count can reduce rN and improve the survival rate of gastric cancer patients. Huang CM, Lin JX, Zheng CH, Li P, Xie JW, Lin BJ, Wang JB. Prognostic impact of metastatic lymph node ratio on gastric cancer after curative distal gastrectomy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prognostic impact of metastatic lymph node ratio on gastric cancer after curative distal gastrectomy

Huang

Lin²,

Zheng³

et al. 2010

WJG

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“…According to recent reports, the proportion between metastatic and examined lymph nodes (N-ratio) has been proposed as an independent prognostic factor of survival in patients with gastric cancer. 45,46 Marchet et al have demonstrated, in a large cohort of patients who underwent radical resection for gastric carcinoma, 46 that age, T-category, type of resection and N-ratio were independent predictors of survival. So, data on quality and type of current surgical procedures are needed to obtain comparable data on efficacy and safety, particularly regarding the type of resection, the extension of lymph node surgical dissection and the N-ratio.…”

Section: Discussionmentioning

confidence: 99%

“…So, data on quality and type of current surgical procedures are needed to obtain comparable data on efficacy and safety, particularly regarding the type of resection, the extension of lymph node surgical dissection and the N-ratio. 46 Finally, we should be particularly concerned about publication bias in settings in which small studies are being conducted. The risk of having missed or overlooked trials in this setting was substantial, as assessed by tests for publication bias and funnel plot.…”

Section: Discussionmentioning

confidence: 99%

The impact of radiotherapy on survival in resectable gastric carcinoma: A meta-analysis of literature data

Fiorica¹,

Cartei²,

Enea

et al. 2007

Cancer Treatment Reviews

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“…Okajima [16] indicated that the anatomic distribution of a metastatic lymph node had prognostic importance. Marchet et al [17] conducted D1, D2, and D3 dissections on 1853 gastric cancer patients; they identified that the metastatic lymph node ratio was the most important prognostic factor, regardless of the dissection type and number of metastatic lymph nodes. [18].…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors that Affect the Survival of Gastric Cancer

Yücel¹,

Kılıçkap²,

Okur³

et al. 2012

CMJ

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Aims. The purpose of this study is to review the factors that affect the survival and clinicopathological characteristics of gastric cancer cases monitored and treated at our centre. Method. 112 gastric cancer patients who admitted to the Radiation Oncology Department of Cumhuriyet University Medical Faculty Research and Application Hospital between 2006 and 2010 were included in the study. The demographic, clinical, and histopathology data of the patients were obtained from the patient files and the hospital records. Results. This study analysed data of 112 patients of whom 90 (80%) were men, and 22 (20%) were women. The factors that determined survival were stage of the cancer, T and N stages, high grade, performance status, presence of anemia and hypoalbuminemia, presence of metastasis, extravascular invasion, weight loss, metastatic lymph node ratio (>50%) and a high level of serum CEA and CA19-9. The stage, performance status, anemia at the time of diagnosis were determined as independent prognostic factors that affect survival after performing multivariate analysis. Conclusion. Many studies have defined numerous prognostic factors for gastric cancer. In concordance with the literature, this study sets forth that the most important factors in terms of prognosis are the stage, the performance status, and the presence of anemia at diagnosis the time of diagnosis.

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The prognostic value of N-ratio in patients with gastric cancer: Validation in a large, multicenter series

Cited by 106 publications

References 26 publications

Prognostic impact of metastatic lymph node ratio on gastric cancer after curative distal gastrectomy

Prognostic impact of metastatic lymph node ratio on gastric cancer after curative distal gastrectomy

The impact of radiotherapy on survival in resectable gastric carcinoma: A meta-analysis of literature data

Prognostic Factors that Affect the Survival of Gastric Cancer

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