Ahmet Bilici1, Fatih Selcukbiricik2, Mesut Seker3, Basak B Oven4, Omer Fatih Olmez5, Ozcan Yildiz5, Oktay Olmuscelik5, Jamshid Hamdard5, Ozgur Acikgoz5, Asli Cakir6, Yersu Kapran7, Emre Balik8, Mustafa Oncel9. 1. Medipol University, Medical Faculty, Department of Medical Oncology, Istanbul, Turkey, ahmetknower@yahoo.com. 2. Koc University,<bold></bold> Medical Faculty, Department of Medical Oncology, Istanbul, Turkey. 3. Bezmialem Vakif University, Medical Faculty, Department of Medical Oncology, Istanbul, Turkey. 4. Bahcesehir University, Medical Faculty, Department of Medical Oncology, Istanbul, Turkey. 5. Medipol University, Medical Faculty, Department of Medical Oncology, Istanbul, Turkey. 6. Medipol University, Medical Faculty, Department of Pathology, Istanbul, Turkey. 7. Koc University, Medical Faculty, Department of Pathology, Istanbul, Turkey. 8. Koc University, Medical Faculty, Department of Surgical Oncology, Istanbul, Turkey. 9. Medipol University, Medical Faculty, Department of Surgical Oncology, Istanbul, Turkey.
Abstract
BACKGROUND: Lymph node involvement is an important prognostic factor in patients with gastric cancer. The aim of this study was to determine the prognostic significance of metastatic lymph node ratio (MLNR) and compare it to the number of lymph node metastasis in pN3 gastric cancer. METHODS: We retrospectively analyzed 207 patients with pN3 gastric cancer who had undergone radical gastrectomy. Prognostic factors and MLNR were evaluated by univariate and multivariate analysis. RESULTS: An MLNR of 0.75 was found to be the best cut-off value to determine the prognosis of patients with pN3 gastric cancer (p = 0.001). The MLNR was significantly higher in patients with large-sized and undifferentiated tumors, vascular, lymphatic and perineural invasion, and total gastrectomy. In multivariate analysis, MLNR (p = 0.041), tumor differentiation (p = 0.046), and vascular invasion (p = 0.012) were found to be independent prognostic factors for disease-free survival, while both MLNR (p < 0.001) and pN stage (p = 0.002) were independent prognostic indicators, as was tumor size, for overall survival. There was significant difference with respect to the recurrence patterns between MLNR groups. Lymph node and peritoneal recurrences were significantly higher in patients with MLNR > 0.75 compared to the MLNR < 0.75 group (p < 0.05). However, recurrence patterns were similar between pN3a and pN3b. CONCLUSION: Our results showed that MLNR was a useful indicator to determine the prognosis and recurrence patterns of patients with radically resected gastric cancer. Moreover, MLNR is a beneficial and reliable technique for evaluating lymph node metastasis.
BACKGROUND: Lymph node involvement is an important prognostic factor in patients with gastric cancer. The aim of this study was to determine the prognostic significance of metastatic lymph node ratio (MLNR) and compare it to the number of lymph node metastasis in pN3gastric cancer. METHODS: We retrospectively analyzed 207 patients with pN3gastric cancer who had undergone radical gastrectomy. Prognostic factors and MLNR were evaluated by univariate and multivariate analysis. RESULTS: An MLNR of 0.75 was found to be the best cut-off value to determine the prognosis of patients with pN3gastric cancer (p = 0.001). The MLNR was significantly higher in patients with large-sized and undifferentiated tumors, vascular, lymphatic and perineural invasion, and total gastrectomy. In multivariate analysis, MLNR (p = 0.041), tumor differentiation (p = 0.046), and vascular invasion (p = 0.012) were found to be independent prognostic factors for disease-free survival, while both MLNR (p < 0.001) and pN stage (p = 0.002) were independent prognostic indicators, as was tumor size, for overall survival. There was significant difference with respect to the recurrence patterns between MLNR groups. Lymph node and peritoneal recurrences were significantly higher in patients with MLNR > 0.75 compared to the MLNR < 0.75 group (p < 0.05). However, recurrence patterns were similar between pN3a and pN3b. CONCLUSION: Our results showed that MLNR was a useful indicator to determine the prognosis and recurrence patterns of patients with radically resected gastric cancer. Moreover, MLNR is a beneficial and reliable technique for evaluating lymph node metastasis.
Authors: Karol Rawicz-Pruszyński; Bogumiła Ciseł; Radosław Mlak; Jerzy Mielko; Magdalena Skórzewska; Magdalena Kwietniewska; Agnieszka Pikuła; Katarzyna Gęca; Katarzyna Sędłak; Andrzej Kurylcio; Wojciech P Polkowski Journal: Cancers (Basel) Date: 2019-12-01 Impact factor: 6.639
Authors: Joonseon Park; Chul Hyo Jeon; So Jung Kim; Ho Seok Seo; Kyo Young Song; Han Hong Lee Journal: J Gastric Cancer Date: 2021-03-26 Impact factor: 3.720