title: The staging system of metastatic lymph node ratio in gastric cancer.
abstract: OBJECTIVE
  The metastatic lymph node ratio (MLR) was proposed as an indicator of prognosis. But, there is disagreement over the use of staging standards based on the MLR. The aim of this study was to define a staging system of metastatic lymph node ratio (MLR) in gastric cancer that could be used to predict the postoperative survival time.
  
  
  METHODS
  A total of 217 patients with gastric cancer were studied retrospectively. MLR was defined as the ratio of the number of metastatic lymph nodes to the total number of lymph nodes found in pathological examination. The patients were stratified into ten subgroups based on 10% MLR intervals. The 2-year cumulative survival rates of each subgroup were calculated using the Kaplan-Meier method and compared using the log rank test. Four MLR stages were determined based on survival rates, and a staging system of MLR was established. The 2-year survival rates of patients classified by a staging system of MLR were calculated and compared to evaluate the effectiveness of the staging system developed.
  
  
  RESULTS
  Four stages of MLR were defined: 0, 0-0.3, 0.3-0.6, >0.6. The 2-year survival rate decreased as MLR increased: 98.1% for MLR 0; 79.1% for MLR 0-0.3; 52.2% for MLR 0.3-0.6; and 30.1% for MLR >0.6. Significant differences in survival rates were found among the four subgroups of patients.
  
  
  CONCLUSIONS
  The staging system of MLR in our study is a reasonable categorization that can be used to objectively predict prognosis of gastric cancer.
authors.affiliation: Department of General Surgery, Liaocheng People's Hospital, Liaocheng, Shandong Province, China. junxiuyu@hotmail.com
authors.forename: Junxiu
authors.initials: J
authors.lastname: Yu
authors.forename: Daogui
authors.initials: D
authors.lastname: Yang
authors.forename: Facai
authors.initials: F
authors.lastname: Wei
authors.forename: Yongling
authors.initials: Y
authors.lastname: Sui
authors.forename: Hongguang
authors.initials: H
authors.lastname: Li
authors.forename: Feng
authors.initials: F
authors.lastname: Shao
authors.forename: Yuan
authors.initials: Y
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology*