Predictive value of positive lymph node ratio in patients with locally advanced gastric remnant cancer

Meng Zhuo ¹, Lei Tian ², Ting Han ¹

⁰Department of Oncology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China.

World Journal of Gastrointestinal Oncology +

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April 5, 2024

View abstract on PubMed

Summary

The positive lymph node ratio (LNR) offers a better prediction of survival in advanced gastric remnant cancer (GRC) than traditional N stage. This new LNR staging system can significantly differentiate overall survival outcomes.

Area Of Science

Oncology
Surgical Oncology
Gastroenterology

Background

Advanced gastric remnant cancer (GRC) staging requires improved prognostic indicators.
Traditional lymph node staging (N stage) has limitations in predicting outcomes for GRC patients.

Purpose Of The Study

To evaluate the predictive value of the positive lymph node ratio (LNR) in locally advanced GRC.
To correlate LNR with clinicopathological features and patient prognosis.

Main Methods

Retrospective review of 74 locally advanced GRC patients undergoing radical gastrectomy and lymphadenectomy.
Analysis of the relationship between LNR and clinicopathological characteristics.
Survival analysis using Kaplan-Meier curves and Cox regression.

Main Results

LNR correlated with metastatic lymph nodes, tumor size, invasion depth, Borrmann type, tumor biomarkers, and TNM stage.
Factors affecting survival included tumor diameter, anemia, biomarkers, invasion, resection, LNR, N stage, and TNM stage.
Median survival decreased significantly with increasing LNR stage (LNR0: 61 mo, LNR1: 31 mo, LNR2: 23 mo, LNR3: 17 mo).
Anemia, tumor biomarkers, and LNR stage were independent prognostic factors.

Conclusions

The novel LNR staging system, based on metastatic lymph nodes, provides significant prognostic value for locally advanced GRC.
LNR stage better differentiates overall survival in GRC compared to the traditional N stage.

Keywords:

Clinicopathological characteristics Gastric remnant cancer Positive lymph node ratio Prognosis