| Turkish Journal of Cancer |
| 2009, Volume 39, Number 4, Page(s) 148-156 |
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| Shall metastatic lymph node ratio be accepted as a prognostic factor in the patients underwent lymphadenectomy with inadequate lymph nodes for gastric cancer? |
| SEZAİ DEMİRBAŞ1, ERGÜN YÜCEL2, A. ZİYA BALTA2, NAİL ERSÖZ1, HÜSEYİN SİNAN1 |
1Gülhane Military Medical Academy, Department of General Surgery, Ankara-Turkey 2Gülhane Military Medical Academy, Department of General Surgery, İstanbul-Turkey |
A relation between the number of resected lymph node and
the number of metastatic lymph nodes in gastric cancer is
the ratio of lymph nodes demonstrating that pN category
was influenced by the extension of the lymphadenectomy.
The necessity of accurate lymph node staging has been
stated vital while evaluating different treatment consequences.
This study evaluates use of ratio of lymph nodes
as a prognostic factor in the patients with gastric cancer
who underwent the surgery with inadequate lymph nodes
removal. Eighty-eight gastric cancer patients with average
age 64.3 and male/female ratio 1.3/1 were reviewed.
The relation between the number of resected lymph nodes
and the number of metastatic lymph nodes was analysed
according to 2 different staging systems and evaluated
against the other prognostic factors too. Pearson correlation
of the variables and multivariate analysis then ROC
curve analysis were used to collate the ratio and the pN
stage. The number of lymph node metastases increased
with the number of resected lymph nodes but the number
of metastatic lymph node was not adequate to make the
staging true (<15). Though the lymph node ratio is supposed
to be a better prognostic factor than the number of
metastatic lymph nodes no difference had been exposed
favoring the ratio of lymph nodes in the study. ROC curve
of both variables did not show difference (0.692 and 0.709, respectively) but both variables were used as a significant
prognostic factor (p<0.0001). According to the multivariate
analysis the hazard ratio for the pN stages showed a significant
increase (p=0.006, HR=1.8, 95% CI=1.184-2,671)
with significant difference, which favored pN stages as a
better prognostic factor against the ratio. The ratio of the
lymph nodes seems not to be a good prognostic factor in
the patients underwent lymphadenectomy with 15 lymph
nodes or lower. However it needs further evaluation. [Turk
J Cancer 2009;39(4):146-154]
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