A new method for staging gastric cancer in patients over 45 years old based on the lymph node ratio

ObjectiveTo evaluate the utility of lymph node ratio(LNR) in the staging assessment of patients over 45 years old with gastric cancer.

MethodsThe patients aged 45 years or older treated with radical gastrectomy were investigated, the clinicopathological data of recovered lymph nodes(LN) and metastatic lymph nodes(LNs) were collected, and the LNR values were obtained(LNR=LNs/LN).The LNR group with 0.1 intervals was divided into four phases based on the cutoff point of increased hazard ratio(HR).The survival analysis was performed to assess the prognostic value of LNR.

ResultsThe four LNR levels included the LNR0(n=89), LNR1(n=47), LNR2(n=90) and LNR3(n=10).In the multivariate analysis, both N staging and LNR staging showed the significant prognostic value, and which could predict the survival outcome.The incremental changes in the HR among successive stages of LNR staging were greater than those of N staging(HR: the N staging was 1.583, 2.789 and 4.581, and the LNR staging was 1.469, 3.837 and 8.572).

ConclusionsThe LNR staging, a novel and simple marker, has certain clinical application value in predicting the prognosis and recurrence of gastric cancer in patients over 45 years old.