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Evaluation of Lymph Node Staging Systems as Independent Prognosticators in Remnant Gastric Cancer Patients with an Insufficient Number of Harvested Lymph Nodes.

Abstract：

BACKGROUND:The lymph node (LN) ratio (LNR) and the log odds of positive LNs (LODDS) have been proposed as sensitive prognosticators in patients with primary gastric cancer, especially in patients with an insufficient number of harvested LNs. We investigated the association of LNR and LODDS with survival in patients with remnant gastric cancer (RGC) and explored whether these staging methods are prognostic factors in patients with an insufficient number of harvested LNs. METHODS:The present study retrospectively examined 95 patients with RGC who received gastrectomy between January 2000 and December 2018. The patients were classified according to the adjusted X-tile cutoff for LNR and LODDS. The association between survival rates and clinicopathological features was investigated. The predictive accuracy of the LNR and LODDS was compared with that of the Union for International Cancer Control pathological N factor. RESULTS:Multivariate analysis revealed that the LNR and LODDS were independent risk factors for recurrence-free survival (RFS) [hazard ratio (HR) 2.623, p = 0.020; HR 3.404, p = 0.004, respectively] and overall survival (OS) (HR 3.694, p = 0.003; HR 2.895, p = 0.022, respectively) in patients with RGC. Moreover, even in patients with 15 or fewer harvested LNs, only the LNR was a significant independent risk factor for RFS (HR 21.890, p < 0.001) and OS (HR 6.597, p = 0.002). The receiver operating characteristic curves revealed that the prognostic accuracy of the three methods was comparable (p > 0.05). CONCLUSION:LNR has significant prognostic value for patients with RGC, including those with an insufficient number of harvested LNs.

journal_name

Ann Surg Oncol

journal_title

Annals of surgical oncology

authors

Kano K,Yamada T,Yamamoto K,Komori K,Watanabe H,Takahashi K,Maezawa Y,Fujikawa H,Numata M,Aoyama T,Tamagawa H,Cho H,Yukawa N,Yoshikawa T,Rino Y,Masuda M,Ogata T,Oshima T

doi

10.1245/s10434-020-09433-2

subject

Has Abstract

pub_date

2021-01-03 00:00:00

eissn

1068-9265

issn

1534-4681

pii

10.1245/s10434-020-09433-2

pub_type

杂志文章

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Evaluation of Lymph Node Staging Systems as Independent Prognosticators in Remnant Gastric Cancer Patients with an Insufficient Number of Harvested Lymph Nodes.