title: Prognostic significance of the ratio between metastatic and dissected lymph nodes (n ratio) in patients with advanced gastric cancer.
abstract: OBJECTIVE
  To determine the prognostic significance of the ratio between metastatic and dissected lymph nodes (n ratio) in gastric cancer patients.
  
  
  METHODS
  We retrospectively reviewed 777 advanced gastric cancer patients who had undergone curative gastrectomy at our hospital.
  
  
  RESULTS
  The n ratio was significantly greater in cases with a large tumor, undifferentiated tumor, lymphatic vessel invasion, or blood vessel invasion. Furthermore, the n ratio was significantly correlated with the depth of invasion, level of lymph node metastasis, and number of lymph node metastases. The prognosis for gastric cancer patients correlated well with the n ratio. Multivariate analysis indicated that the n ratio, but not the number of lymph node metastases, was an independent prognostic indicator. Moreover, the n ratio was an independent prognostic factor in N1, N2, and N3 patients defined by the Japanese Classification of Gastric Cancer (JCGC).
  
  
  CONCLUSIONS
  The n ratio is useful for evaluating the status of lymph node metastasis in gastric cancer. Therefore, the addition of the n ratio to the N (nodal) category defined by the JCGC may be a useful strategy in the N-staging classification of gastric cancer.
authors.affiliation: Department of Surgery, Division of Surgical Oncology, Tottori University School of Medicine, Yonago, Japan. sai10@grape.med.tottori-u.ac.jp
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Saito
authors.forename: Yoji
authors.initials: Y
authors.lastname: Fukumoto
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Osaki
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Yamada
authors.forename: Kenji
authors.initials: K
authors.lastname: Fukuda
authors.forename: Shigeru
authors.initials: S
authors.lastname: Tatebe
authors.forename: Shunichi
authors.initials: S
authors.lastname: Tsujitani
authors.forename: Masahide
authors.initials: M
authors.lastname: Ikeguchi
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D008197:Lymph Node Excision / Q000706:statistics & numerical data; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*