BACKGROUND/AIMS: The metastatic lymph node ratio (MLR) was proposed as an indicator of prognosis. But, there is disagreement over the use of staging standards based on the MLR. The aim of this study was to define a staging system of metastatic lymph node ratio (MLR) in gastric cancer that could be used to predict the postoperative survival time. METHODOLOGY: A total of 217 patients with gastric cancer were studied retrospectively. MLR was defined as the ratio of the number of metastatic lymph nodes to the total number of lymph nodes found in pathological examination. The patients were stratified into ten subgroups based on 10% MLR intervals. The 2-year cumulative survival rates of each subgroup were calculated using the Kaplan-Meier method and compared using the log rank test. Four MLR stages were determined based on survival rates, and a staging system of MLR was established. The 2-year survival rates of patients classified by a staging system of MLR were calculated and compared to evaluate the effectiveness of the staging system developed. RESULTS: Four stages of MLR were defined: 0, 0-0.3, 0.3-0.6, >0.6. The 2-year survival rate decreased as MLR increased: 98.1% for MLR 0; 79.1% for MLR 0-0.3; 52.2% for MLR 0.3-0.6; and 30.1% for MLR >0.6. Significant differences in survival rates were found among the four subgroups of patients. CONCLUSIONS: The staging system of MLR in our study is a reasonable categorization that can be used to objectively predict prognosis of gastric cancer.
BACKGROUND/AIMS: The metastatic lymph node ratio (MLR) was proposed as an indicator of prognosis. But, there is disagreement over the use of staging standards based on the MLR. The aim of this study was to define a staging system of metastatic lymph node ratio (MLR) in gastric cancer that could be used to predict the postoperative survival time. METHODOLOGY: A total of 217 patients with gastric cancer were studied retrospectively. MLR was defined as the ratio of the number of metastatic lymph nodes to the total number of lymph nodes found in pathological examination. The patients were stratified into ten subgroups based on 10% MLR intervals. The 2-year cumulative survival rates of each subgroup were calculated using the Kaplan-Meier method and compared using the log rank test. Four MLR stages were determined based on survival rates, and a staging system of MLR was established. The 2-year survival rates of patients classified by a staging system of MLR were calculated and compared to evaluate the effectiveness of the staging system developed. RESULTS: Four stages of MLR were defined: 0, 0-0.3, 0.3-0.6, >0.6. The 2-year survival rate decreased as MLR increased: 98.1% for MLR 0; 79.1% for MLR 0-0.3; 52.2% for MLR 0.3-0.6; and 30.1% for MLR >0.6. Significant differences in survival rates were found among the four subgroups of patients. CONCLUSIONS: The staging system of MLR in our study is a reasonable categorization that can be used to objectively predict prognosis of gastric cancer.
Authors: Ugwuji N Maduekwe; Gregory Y Lauwers; Carlos Fernandez-Del-Castillo; David L Berger; Charles M Ferguson; David W Rattner; Sam S Yoon Journal: Ann Surg Oncol Date: 2010-01-23 Impact factor: 5.344