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KMID : 0371320060700060437
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Journal of the Korean Surgical Society
2006 Volume.70 No. 6 p.437 ~ p.443
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The Significance of Metastatic Lymph Node Ratio in the Survival Rate of pT2 Gastric Cancer
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Park Jong-Ik
Shin Dong-Gue
Jo Ik-Haeng
Yang Dae-Hyun
Lee Hae-Wan
Kim Il-Myung
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Abstract
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Purpose: The number of resected lymph nodes can influence the current N staging. This study examined the significance of the metastatic lymph node ratio on the survival of patients with pT2 gastric cancer.
Methods: The records of 176 patients who had undergone curative gastrectomy and diagnosed with pT2 gastric cancer by pathology, between February 1990 and October 2002 were retrospectively reviewed. Those patients with other organ metastases or those who had undergone a dissection of less than 15 lymph nodes were excluded. The clinicopathologic prognostic variables were evaluated using the SPSS statistical program.
Results: There were 115 men and 61 women with a mean age of 59 years. The median survival period was 93 months (2∼184 months). Metastatic lymph nodes were found in 100 cases (56.8%), a mean of 34.6 lymph nodes were dissected, a mean of 3.2 lymph nodes metastasized, and a mean metastatic lymph node ratio of 0.09 was found. According to the UICC TNM classification, the number of stage IB (N0) cases was 76 (43.2%), stage II (N1) was 74 (42.0%), stage IIIA (N2) was 18 (10.2%), and stage IV (N3) was 8 (4.5%). The overall 5-year survival rate was 75.2%. According to the UICC TNM classification, the 5-year survival rate was stage IB, II, IIIA, and IV was 88.6%, 74.3%, 39.5%, and 33.3%, respectively. The metastatic lymph node ratio (nR) was divided into 4 categories; nR0 (76) = 0, 0＜nR1 (46)＜ 0.1, 0.1≤N nR2 (25)＜0.2, and 0.2≤nR3 (29). The 5-year survival rate for each group was 88.6%, 85.0%, 56.4%, and 38.8%, respectively. The sex, Borrmann type, location of tumor, and differentiations did not affect the overall survival rate.
Conclusion: Metastatic lymph nodes and its ratio are independent prognostic factors (P=0.000). The metastatic lymph node ratio may be a valuable tool for predicting the long- term prognosis of pT2 gastric cancer patients. (J Korean Surg Soc 2006;70:437-443)
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KEYWORD
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pT2 gastric cancer, Metastatic lymph node ratio, 5-year survival rate
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