Lymph Node Ratio as a Risk Factor for Early Recurrence in Older Patients with Stage II/III Gastric Cancer: A...

Area of Science:

• Oncology
• Geriatric Medicine
• Surgical Oncology

Background:

• Older adults with gastric cancer exhibit poorer prognoses compared to younger individuals.
• Early recurrence (within two years post-surgery) is linked to adverse outcomes, but its predictors are not well-defined.
• Identifying risk factors for early recurrence in elderly gastric cancer patients is crucial for improving treatment strategies.

Purpose of the Study:

• To identify clinicopathological predictors of early recurrence in older patients (≥65 years) with stage II/III gastric cancer.
• To analyze the patterns and risk factors associated with early gastric cancer recurrence in the elderly population.

Main Methods:

• Retrospective analysis of 237 elderly patients (≥65 years) with stage II/III gastric cancer who underwent curative surgery.
• Comparison of clinicopathological variables between patients with and without early recurrence.
• Logistic regression analysis to assess independent risk factors for early recurrence.

Main Results:

• Early recurrence was observed in 72 out of 103 (69.9%) recurrent cases among the elderly cohort.
• Distant metastasis was the most frequent recurrence pattern (59.7%), followed by peritoneal (45.8%) and locoregional (33.3%).
• A lymph node ratio (LNR) > 0.17 was identified as an independent predictor of early recurrence (OR, 5.30; 95% CI, 2.07-13.53; p < 0.001).

Conclusions:

• Early recurrence is a significant concern in older patients with stage II/III gastric cancer, predominantly manifesting as distant metastasis.
• An elevated lymph node ratio (LNR > 0.17) is a key predictor of increased early recurrence risk in this demographic.
• Adjuvant chemotherapy showed a non-significant trend towards risk reduction, warranting further investigation in prospective studies.