Lymph Node Yield and Lymph Node Ratio for Prognosis of Long-Term Survival in Gastric Carcinoma

被引：0
作者：
Jannasch, Olof [1 ]
Schwanz, Martin [2 ]
Otto, Ronny [2 ]
Mik, Michal [3 ]
Lippert, Hans [2 ]
Mroczkowski, Pawel [2 ,3 ,4 ]
机构：
[1] Municipial Hosp Magdeburg, Dept Visceral Vasc & Emergency Surg & VIGO, D-39130 Magdeburg, Germany
[2] Otto von Guericke Univ, Inst Qual Assurance Operat Med Ltd, D-39106 Magdeburg, Germany
[3] Med Univ Lodz, Dept Gen & Colorectal Surg, PL-91419 Lodz, Poland
[4] Ruhr Univ Bochum, Univ Hosp Knappschaftskrankenhaus, Dept Surg, Schornau 23-25, D-44892 Bochum, Germany
来源：
CANCERS | 2025年 / 17卷 / 03期
关键词：
gastric cancer; surgery; lymphadenectomy; lymph node ratio; survival; CANCER; NUMBER; DISSECTION; SURGERY; SYSTEM; IMPACT; S-1;
D O I：
10.3390/cancers17030414
中图分类号：
R73 [肿瘤学];
学科分类号：
100214 ;
摘要：
Background: Lymphadenectomy is a fundamental part of surgical strategy in patients with gastric cancer. Lymph node (LN) status is a key point in assessment of prognosis in gastric cancer. The LN ratio (LNR)-number of positive LNs/number of sampled LNs-offers a new approach for predicting survival. The aim of the study was to find factors affecting LN yield and the impact of LNR on 5-year survival. Methods: Prospective multicenter quality assurance study. Only LN-positive patients were included in the LNR calculations. Results: 4946 patients from 149 hospitals were enrolled. The inclusion criteria were met by 1884 patients. Patients were divided into two groups: Group 1 (<16 LN), 456 patients and Group 2 (>= 16 LN), 1428 patients. The multivariate analysis found G2 (OR 1.98; 95%CI 1.11-3.54), G3 (OR 2.15; 95%CI 1.212-3.829), UICC-stage II (OR 1.44; 95%CI 1.01-2.06) and III (OR 1.71; 95%CI 1.14-2.57), age < 70 (OR 1.818 95%CI 1.19-2.78) and female gender (OR 1.37; 95%CI 1.00-1.86) as independent factors of >= 16 LN yield. Patients with a LNR >= 0.4 have a lower probability of survival (p = 0.039 and <0.001) than patients with a LNR = 0.1. Patients with UICC-II have a lower probability of survival than UICC-I (p = 0.023). Age 70-80 (p = 0.045) and > 80 years (p = 0.003) were negative prognostic factors for long-term survival. Conclusion: Long-term survival is directly related to adequate lymphadenectomy. LNR could be superior to pN-stage for estimating survival and adds remarkable nuances in prognosis compared to UICC-stage. LNR also appears valid, even in the case of insufficient LN yield.
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页数：15
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