Metastatic Lymph Node Ratio (Nratio) is an İndependent Parameter of TNM Classification in Gastric Cancer Prognosis

• Published in: Medical journal of Bakirköy 2019-03, Vol.15 (1), p.76-86
• Main Authors: Bademler, Süleyman, Üçüncü, Muhammed, Bulut, Türker, Asoğlu, Oktar
• Format: Article
• Language: eng ; tur
• Subjects: Gastric cancer; Lymphatic system; Medical prognosis; Metastasis
• ISSN: 1305-9319; 1305-9327
• DOI: 10.4274/BTDMJB.galenos.2018.20181213074140

Objective: Lymph node metastasis is known to be an important prognostic factor in the gastric cancers. In different staging classifications, the nodal involvement is evaluated in terms of the location and/or number of the metastatic lymph nodes. However, in the Western countries the minimum number of 15 lymph nodes required for an evaluation has been obtained in only 30% of the radical resections performed in the gastric cancer cases; and due to the heterogeneous survival responses in the same stage patients and the phase shifts, use of the metastatic lymph node ratio (N-ratio) rather than of the total number of positive nodes has recently been recommended for the nodal evaluation. In this study, our main objective is to retrospectively analyze the effect of the prognostic parameters to the five-year survival in the gastric cancers, and to particularly investigate the prognostic value of the N-ratio. Methods: The clinical records and the pathology and operation reports of the 511 patients who underwent curative surgery with a diagnosis of gastric cancer between January 2002 and December 2009 were analyzed retrospectively. The Kaplan-Meier estimator was used in the calculation of survival. The effects of the existing prognostic factors to the five-year survival were studied in univariate analyses (log-rank test) and in multivariate analyses (Cox regression model). The results were examined in a 95% confidence interval and at a p