Abstract:

Herein, we aimed to evaluate the prognostic significance of the ratio of metastatic lymph nodes to the total number of removed lymph nodes (LNR) in Stage 1-3 operated gastric carcinoma (GC). A total of 233 patients with stage 1-3 GC operated between 2012 and 2019 were retrospectively evaluated. Survival curves were constructed using the Kaplan-Meier method. The median number of metastatic and dissected lymph nodes were 5 and 27, respectively, with a median LNR of 0.1. Patients were categorized into two groups as those with a LNR <0.1 and ≥0.1. Median OS in patients with a median LNR of <0.1 and ≥0.1 were 76 vs. 26.9 months (p<0.001). In univariate analysis gender, lymphovascular invasion (LVI), and perineural invasion (PNI) were found to be significant predictors of median OS (p=0.043, <0. 001 and <0.001 respectively. LNR and LVI emerged as independent predictors of OS in the multivariate analyses (p<0.01 and 0.02, respectively). LNR has prognostic significance for OS in operated GC patients where increasing LNR is associated with reduced overall survival. Thus, LNR may be used as a substitute for pathological nodal classification in patients with insufficient lymph nod disection or D1 disection.

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