Positive node‐ratio in curative‐intent treatment for gastric cancer is a strong independent prognostic factor for 5‐year overall survival

2019 ◽  
Author(s):  
Durval R. Wohnrath ◽  
Raphael L. C. Araujo
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Prognostic Factor ◽  
Independent Prognostic Factor ◽  
Positive Node ◽  
Curative Intent ◽  
Node Ratio

scholarly journals Study of Survival in Gastric Cancer with Emphasis on Lymph Node Status as an Independent Prognostic Factor

2019 ◽  
Vol 4 (4) ◽  
pp. 185-189
Author(s):  
Nicolae Suciu ◽  
Orsolya Bauer ◽  
Zalán Benedek ◽  
Radu Ghenade ◽  
Marius Coroș ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Prognostic Factor ◽  
Lymph Nodes ◽  
Vascular Invasion ◽  
Lymph Node Ratio ◽  
Independent Prognostic Factor ◽  
Lymph Node Status ◽  
Node Ratio ◽  
Gastric Cancer Patients

Abstract Background: Lymph node status in gastric cancer is known as an independent prognostic factor that guides the surgical and oncological treatment and independently influences long-term survival. Several studies suggest that the lymph node ratio has a greater importance in survival than the number of metastatic lymph nodes. Aim: The aim of this study was to evaluate the clinical and morphological factors that can influence the survival of gastric cancer patients, with an emphasis on nodal status and the lymph node ratio. Material and methods: We conducted a retrospective study in which 303 patients with gastric cancer admitted to the Department of Surgery of the Mureș County Hospital between 2008 and 2018 were screened for study enrolment. Data were obtained from the records of the department and from the histopathological reports. The examined variables included: age, gender, tumor localization, T stage, histological type, grade of differentiation, surgical procedure, lympho-vascular invasion, excised lymph nodes, metastatic lymph nodes, lymph node ratio. After screening, the study included a total number of 100 patients, for which follow-up data was available. Results: The mean age of the study population was 66.43 ± 10 years, and 71% were males. The average survival period was 21.42 months. Statistical analysis showed that the localization of the tumor (p = 0.021), vascular invasion (p ---lt---0.001), T (p = 0.004) and N (p ---lt---0.001) stages, type of surgery (partial gastrectomy 59% vs. total gastrectomy 41%, p = 0.005), as well as the lymph node ratio (p ---lt---0.001) were prognostic factors for survival in patients with gastric cancer undergoing surgical therapy. Conclusions: The survival of gastric cancer patients is significantly influenced by tumor localization, T stage, vascular invasion, type of surgery, N stage and the lymph node ratio based on univariate analysis. Also, the lymph node ratio proved to be an independent prognostic factor for survival.

scholarly journals Lymph Node Ratio Predicts Overall Survival in pT4 Gastric Cancer Patients who Underwent Curative Surgery

2021 ◽  
Author(s):  
Fan Yang ◽  
Xinying Yu ◽  
Qi Li ◽  
Jun Wu ◽  
Yang Chen ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Lymph Node ◽  
Prognostic Factor ◽  
Lymph Nodes ◽  
Prognostic Value ◽  
Lymph Node Ratio ◽  
Curative Surgery ◽  
Cutoff Values ◽  
Node Ratio

Abstract Background: Lymph node ratio (LNR), the ratio of metastatic lymph nodes to the total number of examined lymph nodes, has been considered a prognostic factor in gastric cancer (GC) patients. However, the predictive values of LNR vary as characteristics of patients are different. We confirmed its prognostic value and investigated the differences between patients with different pathological features.Methods: Totally, 211 GC patients who underwent curative gastrectomy between October 2004 and November 2016 were retrospectively investigated. Patients were classified into LNR 0, 1 and 2, using cutoff values 0.05 and 0.2. Cutoff values were calculated by Youden index. Relationships between LNR and clinicopathological characteristics were investigated by chi-square test or Fisher's exact test. Survival analysis were based on Cox proportional hazard regression model and Kaplan-Meier method.Results: LNR were related to tumor size (p = 0.003), Lauren classification (p = 0.007), grade of differentiation (p = 0.041), pT stage (p = 0.050) and pN stage (p < 0.001). In multivariable analysis, LNR was an independent prognostic factor (HR = 7.023, p < 0.001). In stratification analysis, LNR showed independent prognostic value (HR = 4.852, p < 0.001) in pT4 patients, but not in pT3 patients (p = 0.361) and pT1-2 patients (p = 0.123). Conclusions: LNR is an independent predictor of overall survival in pT4 GC patients who underwent curative surgery.

scholarly journals Clinical Significance of Preoperative Albumin and Globulin Ratio in Patients with Gastric Cancer Undergoing Treatment

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Min-jie Mao ◽  
Xiao-li Wei ◽  
Hui Sheng ◽  
Xue-ping Wang ◽  
Xiao-hui Li ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Multivariate Analysis ◽  
Prognostic Factor ◽  
Median Overall Survival ◽  
Cox Regression ◽  
Independent Prognostic Factor ◽  
Validation Group ◽  
Kaplan Meier ◽  
Testing Group

Background. The pretreatment albumin and globulin ratio (AGR) was an inflammation-associated factor which was related to the overall survival in various malignancies. The aim of this study was to evaluate the prognostic value of AGR in patients with gastric cancer. Method. This retrospective study included 862 cases pathologically diagnosed with gastric cancer. All patients were randomly divided into the testing group (431 cases) and validation group (431 cases). The relationships of AGR with clinicopathologic characteristics and prognosis were analyzed by Kaplan-Meier and Cox regression methods. Results. In the testing group, the median overall survival was 26.90 months and the cutoff value of AGR was 1.50 based on R language. Kaplan-Meier analysis showed that lower AGR was correlated with poorer overall survival. Multivariate analysis demonstrated that AGR was an independent prognostic factor for overall survival (HR: 0.584, 95% CI = 0.351–0.973, and p = 0.039). In the validation group, the median overall survival was 24.10 months. Lower AGR (≤1.50) also had a significantly poorer overall survival by Kaplan-Meier analysis. According to multivariate analysis, the AGR was also confirmed to be an independent prognostic factor for overall survival (HR: 0.578, 95% CI = 0.373–0.897, and p = 0.015). Conclusions. Our study suggested that the pretreatment AGR could be a prognostic biomarker for overall survival in patients with gastric cancer.

scholarly journals Preoperative neutrophil-to-lymphocyte ratio behaves as an independent prognostic factor even in patients with postoperative complications after curative resection for gastric cancer

2022 ◽  
Author(s):  
Jaume Tur-Martínez ◽  
Javier Osorio ◽  
Noelia Pérez-Romero ◽  
Noelia Puértolas-Rico ◽  
Manuel Pera ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Multivariate Analysis ◽  
Prognostic Factor ◽  
Postoperative Complications ◽  
Gastric Adenocarcinoma ◽  
Independent Prognostic Factor ◽  
Neutrophil To Lymphocyte Ratio ◽  
Term Survival ◽  
Lymphocyte Ratio

Abstract Purpose The aim of this study was to determine if the prognostic value of the preoperative neutrophil-to-lymphocyte ratio (NLR) could be modified by the presence of postoperative complications (POC) and their severity in patients with gastric adenocarcinoma resected with curative intent. Methods A retrospective study based on a prospective database of patients with resectable gastric adenocarcinoma treated with radical intention (R0) between January 1998 and February 2012. The primary endpoint was overall survival according to preoperative peripheral blood NLR and postoperative complications. Clinicopathological variables, preoperative blood tests, POC and its severity (Clavien–Dindo classification), type of POC (infectious or not infectious) and mortality were registered. A univariate and multivariate analysis (step forward Cox regression) was performed. The Kaplan–Meier method was used to assess overall survival. Results The 147 patients with gastric cancer who had undergone radical resection were included from an initial cohort of 209 patients. Univariant analysis: type of surgery, pT, pN, postoperative complications (Clavien–Dindo ≥ 3) and preoperative NLR ≥ 2.4 were significantly associated with survival (p < 0.05). Patients with POC showed worse long-term survival (p = 0.000), with no difference (p = 0.867) between infectious or non-infectious POC. NLR ≥ 2.4 was associated with infectious POC (p < 0.001). Patients with preoperative NLR ≥ 2.4 (p = 0.02) had a worse prognosis. Multivariate analysis: pN (p < 0.001), postoperative complications (p < 0.001) (HR 3.04; 95% CI: 1.97–4.70) and NLR ≥ 2.4 (p = 0.04) (HR = 1.55; 95% CI: 1.02–2.3) were independent prognostic factors. Conclusion The preoperative inflammatory state of patients with gastric cancer measured by NLR behaves as an independent prognostic factor, even in patients with POC.

scholarly journals Positive lymph node ratio is an index in predicting prognosis for remnant gastric cancer with insufficient retrieved lymph node in R0 resection

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Honghu Wang ◽  
Hao Qi ◽  
Xiaofang Liu ◽  
Ziming Gao ◽  
Iko Hidasa ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Ratio ◽  
Prognostic Index ◽  
Staging System ◽  
R0 Resection ◽  
Remnant Gastric Cancer ◽  
Curative Intent ◽  
Node Ratio

AbstractThe staging system of remnant gastric cancer (RGC) has not yet been established, with the current staging being based on the guidelines for primary gastric cancer. Often, surgeries for RGC fail to achieve the > 15 lymph nodes needed for TNM staging. Compared with the pN staging system, lymph node ratio (NR) may be more accurate for RGC staging and prognosis prediction. We retrospectively analyzed the data of 208 patients who underwent R0 gastrectomy with curative intent and who have ≤ 15 retrieved lymph nodes (RLNs) for RGC between 2000 and 2014. The patients were divided into four groups on the basis of the NR cutoffs: rN0: 0; rN1: > 0 and ≤ 1/6; rN2: > 1/6 and ≤ 1/2; and rN3: > 1/2. The 5-year overall survival (OS) rates for rN0, rN1, rN2, and rN3 were 84.3%, 64.7%, 31.5%, and 12.7%, respectively. Multivariable analyses revealed that tumor size (p = 0.005), lymphovascular invasion (p = 0.023), and NR (p < 0.001), but not pN stage (p = 0.682), were independent factors for OS. When the RLN count is ≤ 15, the NR is superior to pN as an important and independent prognostic index of RGC, thus predicting the prognosis of RGC patients more accurately.

HER-2/neu Amplification Is an Independent Prognostic Factor in Gastric Cancer

2006 ◽  
Vol 51 (8) ◽  
pp. 1371-1379 ◽  
Author(s):  
Dong Il Park ◽  
Jung Won Yun ◽  
Jung Ho Park ◽  
Suk Joong Oh ◽  
Hong Joo Kim ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Prognostic Factor ◽  
Independent Prognostic Factor ◽  
Her 2
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