The node ratio as prognostic factor after curative resection for gastric cancer

Area of Science:

• Oncology
• Surgical Pathology
• Cancer Research

Background:

• Tumor invasion depth and nodal involvement are key prognostic factors in gastric cancer.
• Current staging systems lack standardization, necessitating new tools for result interpretation and comparison.
• The node ratio (NR) has emerged as a potential new prognostic indicator.

Purpose of the Study:

• To evaluate the prognostic value of the node ratio (NR) in gastric cancer patients.
• To compare the efficacy of NR with the TNM staging system.
• To assess the impact of the number of retrieved lymph nodes on survival outcomes.

Main Methods:

• Retrospective review of 282 gastric cancer patients undergoing curative resection (2000-2007).
• Analysis included TNM stage, NR, overall survival, and survival based on nodal status and total nodes retrieved.
• Cox regression was used to determine independent prognostic factors.

Main Results:

• Univariate analysis identified TNM stage, metastatic nodes, NR, and invasion depth as significant prognostic factors.
• Patients with >15 retrieved nodes showed significantly longer survival (p < 0.04).
• Node ratio (NR) was confirmed as an independent prognostic factor via Cox regression.

Conclusions:

• Node ratio (NR) is a sensitive and reliable tool for differentiating gastric cancer patient prognoses, potentially surpassing the TNM system.
• NR is not strongly correlated with the number of retrieved nodes, potentially mitigating stage migration.
• Further clinical trials are recommended to validate NR as a prognostic tool.