Enhancement the prediction of postoperative survival in gastric cancer by combining the negative lymph node count with ratio between positive and examined lymph nodes.
BACKGROUND
The purpose of this study was to evaluate the impact of the negative lymph node (NLN) count on the prognostic prediction of the ratio between positive and examined lymph nodes (RML) in gastric cancer after curative resection.


METHODS
The positive and negative node counts were determined for 456 patients who underwent curative resection for gastric cancer. Overall survival was examined according to clinicopathologic variables. The correlation between the NLN count and the aforementioned best variable for prediction the disease-specific overall survival was examined.


RESULTS
The NLN count cutoffs were designed as 0-9, 10-14, and > or =15, with the 5-year survival rate 4.1, 30.7, and 74.8%, respectively. RML of 98 patients who had an NLN count of nine or fewer was > or =40%. The median survival of these patients was 12 months. Of 88 patients who had 10 to 14 NLN count, 7 had 74-month median survival with 0.1-10% RML, 52 had 47-month median survival with 10.1-40% RML, and 29 had 22-month median survival with >40% RML. Of 270 patients who had > or =15 NLN count, 157 had 114-month median survival without positive nodes, 62 had 98-month median survival with 0.1-10% RML, 45 had 40-month median survival with 10.1-40% RML, and 6 had 14-month median survival with >40% RML.


CONCLUSIONS
The NLN count is a key factor for improvement of survival prediction of RML in gastric cancer.
Deng
Jingyu
J
Gastric Cancer Surgery Division, Tianjin Medical University Cancer Hospital and City Key Laboratory of Tianjin Cancer Center, Tianjin, China.
Liang
Han
H
Wang
Dianchang
D
Sun
Dan
D
Ding
Xuewei
X
Pan
Yi
Y
Liu
Xiangyu
X
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult