Evaluating the relation between patients-related factors and dissected lymph node ratio in gastric cancer

Gastric cancer is a forth common malignancy world-wide and the second most common cause of cancer-related deaths. According to the current International Union Against Cancer staging system, nodal status is categorized based on the number of metastatic lymph nodes (LNs). Some groups have recently proposed the metastatic lymph node ratio (MLR) (the ratio between metastatic LNs and total dissected LNs; MLR) as an alternative prognostic factor. The aim of the present study is to evaluate the relationship between MLR and different clinico pathologic factors including patients' age, tumor grade, stage, sites of involvement and disease prognosis.

Atotal of 70 patients with gastric adenocarcinoma who underwent gastrectomy with negative margin and LN resection during 2004-2009 and were referred to Radiotherapy-Oncology Department of Name of Hospital, Name of City, were included in the study. MLR status was divided to five groups. Collected data were analyzed with SPSS 16 (SPSS Inc., Chicago, IL, USA).

The difference between MLR groups in age was significant; older patients had lower MLR (P = 0.01). The ratio of male to female was 5.3, which indicated higher prevalence of gastric cancer in males. The difference between MLR groups for tumor location, tumor stage, disease free periods and tumor T stages were not significant. A significant relation existed between different stages of LN involvement and MLR; and also between cancer stages and MLR.

We found a significant relation between MLR and cancer stage and metastatic LN. Due to small sample size and short period of follow-up, we could not find significant relation between MLR and other factors such as depth of tumor invasion, disease free period and tumor grading. In conclusion with regards to our results and other similar studies' results, we acknowledge the importance of MLR in determining patients' prognosis in gastric cancer.