title: Usefulness of the log odds of positive lymph nodes to predict and discriminate prognosis in gastric carcinomas.
abstract: BACKGROUND
  The lymph node ratio (LNR) and log odds of positive lymph nodes (LODDS) have been proposed to minimize the stage migration phenomenon. The value of the LODDS and LNR staging systems to predict and discriminate prognosis was assessed and compared to the International Union Against Cancer (UICC) TNM classification (pN).
  
  
  METHODS
  Three hundred and twenty-six patients with gastric carcinoma were retrospectively studied. Disease-specific survival rates were calculated for every pN, LNR, and LODDS category.
  
  
  RESULTS
  Four LNR categories (0, 1-25, 26-75, and >76 %) and four LODDS categories (-5 to -3, > -3 to -1, > -1 to 3, and >3 to 5) were established. In the multivariate analysis, only the stage pT3-4 versus pT1-2 (HR 1.88, 95 % CI 1.11-3.20, p=0.02) and LODDS as continuous variable (HR 1.40, 95 % CI 1.21-1.61, p<0.001) remained as independent prognostic factors. In patients with <16 lymph nodes retrieved, only the LODDS system could discriminate different disease-specific survival curves for every category. LODDS categories were able to discriminate subgroups with different prognoses in pN stages and LNR categories.
  
  
  CONCLUSIONS
  The LODDS staging system was superior to the pN classification and LNR system to discriminate risk prognosis especially in patients with an insufficient number of retrieved lymph nodes.
authors.affiliation: Department of General and Digestive Surgery, Hospital General Universitario, Cami de l'Almazara 11, 03203, Elche, Spain, alidoc20@yahoo.es.
authors.forename: A
authors.initials: A
authors.lastname: Calero
authors.forename: J
authors.initials: J
authors.lastname: Escrig-Sos
authors.forename: F
authors.initials: F
authors.lastname: Mingol
authors.forename: A
authors.initials: A
authors.lastname: Arroyo
authors.forename: D
authors.initials: D
authors.lastname: Martinez-Ramos
authors.forename: M
authors.initials: M
authors.lastname: de Juan
authors.forename: J L
authors.initials: JL
authors.lastname: Salvador-Sanchis
authors.forename: E
authors.initials: E
authors.lastname: Garcia-Granero
authors.forename: R
authors.initials: R
authors.lastname: Calpena
authors.forename: F J
authors.initials: FJ
authors.lastname: Lacueva
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000601:surgery; D015996:Survival Rate