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Prognostic value of lymph node staging systems in gastric cancer patients undergoing laparoscopic surgery: A case-series in Vietnam

  • 0Department of Digestive Surgery, Viet Duc University Hospital, Hanoi, Viet Nam; Hanoi Medical University, Hanoi, Viet Nam.
International Journal of Surgery Case Reports +

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October 3, 2025

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October 3, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

The lymph node ratio (LNR) and log odds of positive nodes (LODDS) offer superior prognostic accuracy for gastric cancer (GC) survival compared to the traditional pN system, especially with limited lymph node dissection.

Area Of Science

  • Oncology
  • Surgical Oncology
  • Cancer Staging

Background

  • Lymph node metastasis is a critical prognostic indicator in gastric cancer (GC).
  • The current pN staging system may be limited by not accounting for total lymph nodes dissected, potentially affecting accuracy in cases of suboptimal lymphadenectomy.
  • Alternative staging systems like lymph node ratio (LNR) and log odds of positive nodes (LODDS) may offer improved prognostic value.

Purpose Of The Study

  • To compare the prognostic significance of the lymph node ratio (LNR), log odds of positive nodes (LODDS), and the number of positive lymph nodes (pN) in gastric cancer patients.
  • To evaluate the effectiveness of these systems, particularly in patients with fewer than 15 dissected lymph nodes.

Main Methods

  • Retrospective analysis of 86 gastric cancer patients who underwent curative laparoscopic surgery.
  • Survival outcomes were assessed using Kaplan-Meier analysis and log-rank tests.
  • Prognostic accuracy was determined using receiver operating characteristic (ROC) curves and area under the curve (AUC) values.

Main Results

  • All three systems (pN, LNR, LODDS) were found to be significant prognostic factors for gastric cancer survival (p=0.007, 0.002, 0.036, respectively).
  • In patients with fewer than 15 lymph nodes dissected, only the LNR system maintained prognostic significance (p=0.037).
  • Both LNR and LODDS were effective in the subgroup with 15 or more lymph nodes dissected.

Conclusions

  • LNR and LODDS are recommended for evaluating lymph node metastasis in gastric cancer, especially when lymph node dissection is inadequate.
  • This study supports the integration of LNR and LODDS as complementary prognostic tools for gastric cancer staging in Vietnam.
  • These advanced methods can enhance the accuracy of staging and prognosis for gastric cancer patients.

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