BACKGROUND: Depth of tumor invasion (T-category) and the number of metastatic lymph nodes (N-category) are the most important prognostic factors in patients with gastric cancer. Recently, the ratio between metastatic and dissected lymph nodes (N-ratio) has been established as one. The aim of this study is to evaluate the impact of N-ratio and its interaction with N-category as a prognostic factor in gastric cancer. METHODS: This was a retrospective study in which we reviewed clinical and pathological data of 165 patients who had undergone curative surgery at our institution through a 9-year period. The exclusion criteria included metastases, gastric stump tumors and gastrectomy with less than 15 lymph nodes dissected. RESULTS: The median age of the patients was 63 years and most of them were male. Total gastrectomy was the most common procedure and 92.1% of the patients had a D2-lymphadenectomy. Their 5-year overall survival was 57.7%. T-category, N-category, extended gastrectomy, and N-ratio were prognostic factors in overall and disease-free survival in accordance with univariate analysis. In accordance with TNM staging, N1 patients who have had NR1 had 5-year survival in 75.5% whereas in the NR2 group only 33% of the cases had 5-year survival. In the multivariate analysis, the interaction between N-category and N-ratio was an independent prognostic factor. CONCLUSION: Our findings confirmed the role of N-ratio as prognostic factor of survival in patients with gastric cancer surgically treated with at least 15 lymph nodes dissected. The relationship between N-category and N-ratio is a better predictor than lymph node metastasis staging.
BACKGROUND: Depth of tumor invasion (T-category) and the number of metastatic lymph nodes (N-category) are the most important prognostic factors in patients with gastric cancer. Recently, the ratio between metastatic and dissected lymph nodes (N-ratio) has been established as one. The aim of this study is to evaluate the impact of N-ratio and its interaction with N-category as a prognostic factor in gastric cancer. METHODS: This was a retrospective study in which we reviewed clinical and pathological data of 165 patients who had undergone curative surgery at our institution through a 9-year period. The exclusion criteria included metastases, gastric stump tumors and gastrectomy with less than 15 lymph nodes dissected. RESULTS: The median age of the patients was 63 years and most of them were male. Total gastrectomy was the most common procedure and 92.1% of the patients had a D2-lymphadenectomy. Their 5-year overall survival was 57.7%. T-category, N-category, extended gastrectomy, and N-ratio were prognostic factors in overall and disease-free survival in accordance with univariate analysis. In accordance with TNM staging, N1 patients who have had NR1 had 5-year survival in 75.5% whereas in the NR2 group only 33% of the cases had 5-year survival. In the multivariate analysis, the interaction between N-category and N-ratio was an independent prognostic factor. CONCLUSION: Our findings confirmed the role of N-ratio as prognostic factor of survival in patients with gastric cancer surgically treated with at least 15 lymph nodes dissected. The relationship between N-category and N-ratio is a better predictor than lymph node metastasis staging.
Authors: Emne A Abdallah; Alexcia C Braun; Bianca C T C P Flores; Laís Senda; Ana Cláudia Urvanegia; Vinicius Calsavara; Victor Hugo Fonseca de Jesus; Maria Fernanda Arruda Almeida; Maria Dirlei Begnami; Felipe J F Coimbra; Wilson Luiz da Costa; Diana Noronha Nunes; Emmanuel Dias-Neto; Ludmilla T Domingos Chinen Journal: Oncologist Date: 2019-03-07
Authors: Wilson L Costa; Felipe J F Coimbra; Héber S C Ribeiro; Alessandro L Diniz; André Luís de Godoy; Mariadirleifs Begnami; Milton J B Silva; Marcelo F Fanelli; Celso A L Mello Journal: World J Surg Oncol Date: 2012-09-19 Impact factor: 2.754
Authors: Youjin Kim; Se Hoon Park; Kyoung-Mee Kim; Min Gew Choi; Jun Ho Lee; Tae Sung Sohn; Jae Moon Bae; Sung Kim; Su Jin Lee; Seung Tae Kim; Jeeyun Lee; Joon Oh Park; Young Suk Park; Ho Yeong Lim; Won Ki Kang Journal: J Gastric Cancer Date: 2016-06-24 Impact factor: 3.720
Authors: Wilson L Costa; Felipe J F Coimbra; Ricardo C Fogaroli; Héber S C Ribeiro; Alessandro L Diniz; Maria Dirlei F L Begnami; Celso A L Mello; Marcelo F Fanelli; Milton J B Silva; José Humberto Fregnani; André L Montagnini Journal: Radiat Oncol Date: 2012-10-15 Impact factor: 3.481