Prognostic Value of Lymph Node Ratio in Patients Receiving Combined Surgical Resection for Gastric Cancer Liver Metastasis: Results from Two National Centers in China.
The purpose of this study was to evaluate the prognostic value of lymph node ratio (LNR) in patients with gastric cancer liver metastasis (GCLM) who received combined surgical resection. A retrospective analysis of 46 patients from two hospitals was conducted. Patients were dichotomized into two groups (high LNR and low LNR) by the median value of LNR. The overall survival (OS) and recurrence-free survival (RFS) were analyzed by the Kaplan-Meier method with the log-rank test. The Cox proportional hazard model was used to carry out the subsequent multivariate analyses. And the relationship between LNR and clinicopathological characteristics was assessed. The cut-off value defining elevated LNR was 0.347. With a median follow-up of 67.5 months, the median OS and RFS of the patients were 17 and 9.5 months, respectively. Six patients survived for >5 years after surgery. Patients with higher LNR had significantly shorter OS and RFS than those with lower LNR. In the multivariate analyses, higher LNR and multiple liver metastatic tumors were identified as the independent prognostic factors for both OS and RFS. Elevated LNR was significantly associated with advanced pN stage (P <0.001), larger primary tumor size (P = 0.046), the presence of microvascular invasion (P = 0.008), and neoadjuvant chemotherapy (P = 0.004). LNR may be prognostic indicator for patients with GCLM treated by synchronous surgical resection. Patients with lower LNR and single liver metastasis may gain more survival benefits from the surgical resection. Further prospective studies with reasonable study design are warranted.
From the Department of Abdominal Surgical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), No. 17, Panjiayuan Nanli (M-XL, Z-XJ, J-GZ, X-YB, J-JZ, Z-YL, ZH, Y-FZ, YL, XC, X-HH, H-JH, D-BZ, J-QC, HZ); Department of Medical Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), No. 1 ShuaiFuYuan Hutong (Y-YW); Department of Pathology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), No.17, Panjiayuan Nanli (J-MY); Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), No. 1 ShuaiFuYuan Hutong (Z-YL, X-XM); and Peking Union Medical College, Chinese Academy of Medical Sciences, No. 5 DongDanSanTiao, Beijing, People's Republic of China (Z-XJ).
Mu-Xing
MX
Li
Zheng-Xiong
ZX
Jin
Jian-Guo
JG
Zhou
Jian-Ming
JM
Ying
Zhi-Yong
ZY
Liang
Xin-Xin
XX
Mao
Xin-Yu
XY
Bi
Jian-Jun
JJ
Zhao
Zhi-Yu
ZY
Li
Zhen
Z
Huang
Ye-Fan
YF
Zhang
Yuan
Y
Li
Xiao
X
Chen
Xu-Hui
XH
Hu
Han-Jie
HJ
Hu
Dong-Bing
DB
Zhao
Ying-Yi
YY
Wang
Jian-Qiang
JQ
Cai
Hong
H
Zhao
D000230:Adenocarcinoma / Q000453:epidemiology / Q000556:secondary* / Q000601:surgery; D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D019160:Endosonography; D005260:Female; D005500:Follow-Up Studies; D005773:Gastroscopy; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000453:epidemiology / Q000556:secondary / Q000601:surgery*; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate / Q000639:trends; D013997:Time Factors