title: Superiority of metastatic lymph node ratio to the 7th edition UICC N staging in gastric cancer.
abstract: OBJECTIVE
  To compare and evaluate the appropriate prognostic indicators of lymph node basic staging in gastric cancer patients who underwent radical resection.
  
  
  METHODS
  A total of 1042 gastric cancer patients who underwent radical resection and D2 lymphadenectomy were staged using the 6th and 7th edition International Union Against Cancer (UICC) N staging methods and the metastatic lymph node ratio (MLNR) staging. Homogeneity, discriminatory ability, and gradient monotonicity of the various staging methods were compared using linear trend χ(2), likelihood ratio χ(2) statistics, and Akaike information criterion (AIC) calculations. The area under the curve (AUC) was calculated to compare the predictive ability of the aforementioned three staging methods.
  
  
  RESULTS
  Optimal cut-points of the MLNR were calculated as MLNR0 (0), MLNR1 (0.01-0.30), MLNR2 (0.31-0.50), and MLNR3 (0.51-1.00). In univariate, multivariate, and stratified analyses, MLNR staging was superior to the 6th and 7th edition UICC N staging methods. MLNR staging had a higher AUC, higher linear trend and likelihood ratio χ(2) scores and lower AIC values than the other two staging methods.
  
  
  CONCLUSIONS
  MLNR staging predicts survival after gastric cancer more precisely than the 6th and 7th edition UICC N classifications and should be considered as an alternative to current pathological N staging.
authors.affiliation: Department of Gastrointestinal-pancreatic Surgery, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China. longbinxiao@yahoo.cn
authors.forename: Long-Bin
authors.initials: LB
authors.lastname: Xiao
authors.forename: Jian-Xing
authors.initials: JX
authors.lastname: Yu
authors.forename: Wen-Hui
authors.initials: WH
authors.lastname: Wu
authors.forename: Feng-Feng
authors.initials: FF
authors.lastname: Xu
authors.forename: Shi-Bin
authors.initials: SB
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D013274:Stomach Neoplasms / Q000145:classification* / Q000473:pathology* / Q000601:surgery; D055815:Young Adult