title: Does lymph node ratio affect prognosis in gastroesophageal cancer?
abstract: BACKGROUND
  Increasing evidence suggests that the ratio of number of nodes harboring metastatic cancer to the total number of lymph nodes examined (lymph node ratio, LNR) may affect survival after esophagogastric resection for cancer. We analyzed the impact of LNR in overall survival in patients undergoing esophagogastric resection for cancer.
  
  
  METHODS
  Patients who underwent gastroesophageal resection for cancer (1998 to 2008) were categorized into 4 groups according to their LNR: 113 patients had negative nodes (N0), 86 LNR less than .3, 40 LNR .31 to .6, and 47 LNR greater than .6. Study endpoint was overall median survival.
  
  
  RESULTS
  Higher LNR was associated (P < .001) with more advanced stage and adverse pathologic features (eg, grading, venous/perineural invasion). Multivariate analysis demonstrated that LNR is an independent predictor of survival.
  
  
  CONCLUSIONS
  In our experience, LNR correlates with adverse pathologic features and is a negative prognostic factor in patients undergoing radical resection for gastroesophageal cancer.
authors.affiliation: Department of Surgery, NYU School of Medicine, 550 First Avenue, NBV 15N1, New York, NY 10016, USA. Electronic address: marcovalerio.melis@nyumc.org.
authors.forename: Marcovalerio
authors.initials: M
authors.lastname: Melis
authors.affiliation: Department of Surgery, NYU School of Medicine, 550 First Avenue, NBV 15N1, New York, NY 10016, USA.
authors.forename: Antonio
authors.initials: A
authors.lastname: Masi
authors.affiliation: Department of Surgery, NYU School of Medicine, 550 First Avenue, NBV 15N1, New York, NY 10016, USA; Department of General Surgery, Clinica Chirurgica, University of Sassari, Viale San Pietro 43/B, 07100 Sassari, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Pinna
authors.affiliation: Department of Surgery, NYU School of Medicine, 550 First Avenue, NBV 15N1, New York, NY 10016, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Cohen
authors.affiliation: Department of Surgery, NYU School of Medicine, 550 First Avenue, NBV 15N1, New York, NY 10016, USA.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Hatzaras
authors.affiliation: Department of Surgery, NYU School of Medicine, 550 First Avenue, NBV 15N1, New York, NY 10016, USA.
authors.forename: Russell
authors.initials: R
authors.lastname: Berman
authors.affiliation: Department of Surgery, NYU School of Medicine, 550 First Avenue, NBV 15N1, New York, NY 10016, USA.
authors.forename: Leon H
authors.initials: LH
authors.lastname: Pachter
authors.affiliation: Department of Surgery, NYU School of Medicine, 550 First Avenue, NBV 15N1, New York, NY 10016, USA.
authors.forename: Elliot
authors.initials: E
authors.lastname: Newman
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery
keywords: Gastroesophageal cancer; Lymph node ratio; Prognosis