Clinical Significance of the Metastatic Lymph-Node Ratio in Early Gastric Cancer

  • Chikara Kunisaki
  • Hirochika Makino
  • Hirotoshi Akiyama
  • Yuichi Otsuka
  • Hidetaka A. Ono
  • Takashi Kosaka
  • Ryo Takagawa
  • Yutaka Nagahori
  • Masazumi Takahashi
  • Fumihiko Kito
  • Hiroshi Shimada
Article

DOI: 10.1007/s11605-007-0239-3

Cite this article as:
Kunisaki, C., Makino, H., Akiyama, H. et al. J Gastrointest Surg (2008) 12: 542. doi:10.1007/s11605-007-0239-3
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Abstract

The metastatic lymph-node ratio has important prognostic value in gastric cancer; this study focused on its significance in early gastric cancer. In total, 1,472 patients with early gastric cancer underwent curative gastrectomy between 1992 and 2001. Of these, 166 (11.3%) had histologically proven lymph-node metastasis. Prognostic factors were identified by univariate and multivariate analyses. Metastasis was evaluated using the Japanese Classification of Gastric Carcinoma (JGC) and the Union Internationale Contre le Cancer/Tumor, Node, Metastasis (UICC/TNM) Classification. The metastatic lymph-node ratio was calculated using the hazard ratio. The cut-off values for the metastatic lymph-node ratio were set at 0, <0.15, ≥0.15 to <0.30, and ≥0.30. The numbers of dissected and metastatic lymph nodes were correlated, but the number of dissected lymph nodes and the metastatic lymph-node ratio was not related. The JGC and UICC/TNM classification demonstrated stage migration and heterogeneous stratification for disease-specific survival. The metastatic lymph-node ratio showed less stage migration and homogenous stratification. The metastatic lymph-node ratio may be a superior method of classification, which provides also accurate prognostic stratification for early gastric cancer patients.

Keywords

Early gastric cancer Lymph-node metastasis Metastatic lymph-node ratio Prognostic factors 

Copyright information

© The Society for Surgery of the Alimentary Tract 2007

Authors and Affiliations

  • Chikara Kunisaki
    • 1
    • 2
  • Hirochika Makino
    • 1
    • 2
  • Hirotoshi Akiyama
    • 2
  • Yuichi Otsuka
    • 2
  • Hidetaka A. Ono
    • 2
  • Takashi Kosaka
    • 2
  • Ryo Takagawa
    • 2
  • Yutaka Nagahori
    • 3
  • Masazumi Takahashi
    • 4
  • Fumihiko Kito
    • 4
  • Hiroshi Shimada
    • 2
  1. 1.Department of Surgery, Gastroenterological CenterYokohama City University Graduate School of MedicineYokohamaJapan
  2. 2.Department of Gastroenterological SurgeryYokohama City University Graduate School of MedicineYokohamaJapan
  3. 3.Department of SurgeryYokosuka Kyosai HospitalYokosukaJapan
  4. 4.Department of SurgeryYokohama Municipal HospitalHodogaya-kuJapan