title: Evaluation of the prognostic value of the metastatic lymph node ratio for gastric cancer.
abstract: BACKGROUND
  The aim of this study was to investigate the prognostic value of metastatic lymph node (LN) ratio (LNR) compared with pathologic node (pN) category.
  
  
  METHODS
  Three hundred ninety-nine patients with gastric cancer with R0 resection were reviewed. LNR, pN, and the number of retrieved LNs were evaluated in node-positive groups with ≥15 or <15 LNs resected and a node-negative group, respectively, by univariate and multivariate analyses. Associations of pN and LNR with the number of retrieved LNs were determined using Spearman's rank correlation test.
  
  
  RESULTS
  LNR and pN were correlated with overall survival. For the node-positive group with ≥15 LNs retrieved, pN and LNR were independent prognostic factors, with the hazard ratio higher for LNR; neither was correlated with the number of retrieved LNs. For the group with <15 LNs retrieved, LNR but not pN was an independent prognostic factor, with LNR uncorrelated with the number of LNs retrieved. For the node-negative group, the number of LNs retrieved retained an independent prognostic factor.
  
  
  CONCLUSIONS
  LNR is an independent prognostic factor in node-positive patients with gastric cancer with R0 resection, and it is uninfluenced by the number of LNs retrieved. It may be superior to pN.
authors.affiliation: Department of Pathology, 117 Hospital of Chinese PLA, Hangzhou, China.
authors.forename: Bao-Yan
authors.initials: BY
authors.lastname: Zhang
authors.affiliation: Department of Pathology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Yuan
authors.affiliation: Cadre Ward of Internal Medicine, Chinese PLA General Hospital of Beijing Military Area, Beijing, China.
authors.forename: Zhen-Shuang
authors.initials: ZS
authors.lastname: Cui
authors.affiliation: Department of Pathology, Peking University Cancer Hospital, 52 Fucheng Road, 100142 Beijing, China.
authors.forename: Zhong-Wu
authors.initials: ZW
authors.lastname: Li
authors.affiliation: Department of Pathology, Peking University Cancer Hospital, 52 Fucheng Road, 100142 Beijing, China. Electronic address: lixianghong301@yahoo.com.
authors.forename: Xiang-Hong
authors.initials: XH
authors.lastname: Li
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, 52 Fucheng Road, 100142 Beijing, China. Electronic address: youyonglu@hsc.pku.edu.cn.
authors.forename: You-Yong
authors.initials: YY
authors.lastname: Lu
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D009367:Neoplasm Staging / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000556:secondary; D015996:Survival Rate / Q000639:trends
keywords: Gastric cancer; Metastatic lymph node ratio; Prognosis; TNM; pN category