The Prognostic Value of Lymph Node Ratio after Neoadjuvant Chemotherapy in Patients with Locally Advanced Gastric Adenocarcinoma
- Author:
Kankai ZHU
1
;
Hailong JIN
;
Zhijian LI
;
Yuan GAO
;
Qing ZHANG
;
Xiaosun LIU
;
Jiren YU
Author Information
- Publication Type:Original Article
- From:Journal of Gastric Cancer 2021;21(1):49-62
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:This study aimed to investigate the prognostic value of lymph node ratio (LNR) in patients with locally advanced gastric cancer who received neoadjuvant chemotherapy.
Materials and Methods:We retrospectively enrolled gastric cancer patients treated with neoadjuvant chemotherapy and curative surgery at the First Affiliated Hospital of Zhejiang University from 2004 to 2015 as the study cohort. Patients with the same inclusion criteria treated in 2016–2017 were enrolled as the validation cohort. Kaplan-Meier curves were assessed using the log-rank test to analyze the differences in overall survival (OS).Multivariate survival analysis was performed using the Cox proportional hazards model.The areas under the receiver operating characteristic curve of ypN and LNR categories for predicting the actual 3-year OS were compared.
Results:A total of 265 patients were included in the proposal cohort. The median number of retrieved lymph nodes (rLNs) was 32. The number of positive lymph nodes (pLNs) increased as rLN increased (P=0.037), but the LNR remained relatively constant (P=0.462). The LNR was categorized into 4 groups according to the prognosis: ypNr0, node-negative with rLN>25; ypNr1, node-negative with rLN≤25 or 0
Conclusions:LNR was an independent prognostic factor for survival of patients with gastric cancer after preoperative chemotherapy and might be an alternative predictor for ypN stage.
