The Prognostic Value of Lymph Node Ratio after Neoadjuvant Chemotherapy in Patients with Locally Advanced Gastric Adenocarcinoma

Jiren Yu; Kankai Zhu; Hailong Jin; Zhijian Li; Yuan Gao; Qing Zhang; Xiaosun Liu

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자료유형: 학술저널

저자정보: Jiren Yu (The First Affiliated Hospital Zhejiang University School of Medicine China) Kankai Zhu (The First Affiliated Hospital Zhejiang University School of Medicine China) Hailong Jin (The First Affiliated Hospital Zhejiang University School of Medicine China) Zhijian Li (The First Affiliated Hospital Zhejiang University School of Medicine China) Yuan Gao (The First Affiliated Hospital Zhejiang University School of Medicine China) Qing Zhang (The First Affiliated Hospital Zhejiang University School of Medicine China) Xiaosun Liu (The First Affiliated Hospital Zhejiang University School of Medicine China)

저널정보: 대한위암학회 Journal of Gastric Cancer Journal of Gastric Cancer 제21권 제1호

발행연도: 2021.1

수록면: 49 - 62 (14page)

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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<LNR≤0.1; ypNr2, 0.1<LNR≤0.3; and ypNr3, LNR>0.3. In the validation cohort of 43 enrolled patients, there was a clear distinction in OS that significantly (P<0.001) varied depending on the LNR values and LNR was the only independent prognostic factor in multivariate analysis (P<0.001). 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.

#Stomach neoplasms #Lymph node ratio #Neoadjuvant chemotherapy

참고문헌 (24)

참고문헌 신청

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