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Correlation between lymph node count and survival and a reappraisal of lymph node ratio as a predictor of survival in gastric cancer

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Author(s)
J.H. LeeJ.-W. KangB.-H. NamG.S. ChoW.J. HyungM.C. KimH.-J. LeeK.W. RyuS.W. RyuD.W. ShinC.-Y. Kim
Keimyung Author(s)
Ryu, Seung Wan
Department
Dept. of Surgery (외과학)
Institute for Cancer Research (암연구소)
Journal Title
European Journal of Surgical Oncology
Issued Date
2017
Volume
43
Issue
2
Keyword
Stomach neoplasmLymph nodesSurvival
Abstract
Purpose : The purpose of this study is to evaluate the correlation between lymph node count (LNC) and survival and to evaluate whether lymph node ratio (LNR) which is related to LNC is a better predictor of survival for gastric cancer than the N category of UICC/AJCC through a multi-institutional cohort study.
Methods : The study cohort included 3284 patients from eight institutions. Lower and upper quartiles of LNC were used for comparisons. The cut-off values (0, 0.06, 0.27, and 0.49) for the LNR categories were based on Classification and Regression Trees techniques. Akaike information criteria (AIC) for Cox regression models was used to evaluate goodness of fit between competing predictor variables (LNR vs. N category).
Results : The 5-year disease-specific survival (DSS) rates of lower and upper quartiles of LNC were 82.2% and 84.8%. In the subgroup analysis of pN category, the upper quartile of LNC showed better survival than the lower quartile in pN2, pN3a, and pN3b subgroups. Regarding LNR, 5-year DSS of LNR 0, 0–0.06, 0.06–0.27, 0.27–0.49, and >0.49 was 95.3%, 88.7%, 70.6%, 42.7%, and 17.2% respectively. Multivariate analysis showed that pT, pN, LNR, residual tumor status, distant metastasis, and tumor differentiation significantly affected survival. The analysis also confirmed superiority of LNR compared with N category in the AIC analysis.
Conclusion : Higher LNC correlated with better survival in patients with pN2, pN3a, and pN3b gastric cancer. Our data indicate that LNR is a better predictor of survival than N category of UICC/AJCC.
Keimyung Author(s)(Kor)
류승완
Publisher
School of Medicine
Citation
J.H. Lee et al. (2017). Correlation between lymph node count and survival and a reappraisal of lymph node ratio as a predictor of survival in gastric cancer. European Journal of Surgical Oncology, 43(2), 432–439. doi: 10.1016/j.ejso.2016.09.007
Type
Article
ISSN
0748-7983
Source
https://linkinghub.elsevier.com/retrieve/pii/S0748798316308952
DOI
10.1016/j.ejso.2016.09.007
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/32752
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Surgery (외과학)
3. Research Institutues (연구소) > Institute for Cancer Research (암연구소)
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