title: Determining of metastatic lymph node ratio in patients who underwent D2 dissection for gastric cancer.
abstract: The purpose of this study was to determine outcome of the ratio of metastatic lymph nodes to the total number of dissected lymph nodes (MLR) in patients with gastric cancer. We retrospectively analyzed 111 patients who underwent D(2) lymph node dissection. The prognostic factors including UICC/AJCC TNM classification and MLR were evaluated by univariate and multivariate analysis. The MLR was significantly higher in patients with a larger tumor, lymphatic vessel invasion, blood vessel invasion and perineural invasion, and advanced stage. Moreover, the MLR was significantly associated with the depth of invasion and the number of lymph node metastasis. The univariate analysis revealed for overall survival (OS) that stage of disease, lymphatic vessel invasion, blood vessel invasion, perineural invasion, lymph node metastasis (UICC/AJCC pN stage) and MLR were relevant prognostic indicators. Furthermore, both UICC/AJCC pN stage and MLR were detected as prognostic factor by multivariate analysis, as was perineural invasion. Our results indicated that MLR and UICC/AJCC pN staging system were important prognostic factors for OS of patients with D(2) lymph node dissection in gastric cancer in a multivariate analysis. MLR may be useful for evaluating the status of lymph node metastasis in gastric cancer.
authors.affiliation: Department of Medical Oncology, Dr. Lütfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey. ahmetknower@yahoo.com
authors.forename: Ahmet
authors.initials: A
authors.lastname: Bilici
authors.forename: Mesut
authors.initials: M
authors.lastname: Seker
authors.forename: Bala Basak Oven
authors.initials: BB
authors.lastname: Ustaalioglu
authors.forename: Burcak
authors.initials: B
authors.lastname: Yilmaz
authors.forename: Alper
authors.initials: A
authors.lastname: Doventas
authors.forename: Taflan
authors.initials: T
authors.lastname: Salepci
authors.forename: Mahmut
authors.initials: M
authors.lastname: Gumus
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D002277:Carcinoma / Q000098:blood supply / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000098:blood supply / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D047368:Tumor Burden