Annals of Surgical Oncology

, Volume 9, Issue 1, pp 27–34

The superiority of ratio-based lymph node staging in gastric carcinoma

Authors

    • Second Department of SurgeryKansai Medical University
  • Yasushi Nakane
    • Second Department of SurgeryKansai Medical University
  • Hitoshi Iiyama
    • Second Department of SurgeryKansai Medical University
  • Mutsuya Sato
    • Second Department of SurgeryKansai Medical University
  • Tatsuya Kanbara
    • Second Department of SurgeryKansai Medical University
  • Koji Nakai
    • Second Department of SurgeryKansai Medical University
  • Syunichiro Okumura
    • Second Department of SurgeryKansai Medical University
  • Keigo Yamamichi
    • Second Department of SurgeryKansai Medical University
  • Koshiro Hioki
    • Second Department of SurgeryKansai Medical University
Original Articles

DOI: 10.1245/aso.2002.9.1.27

Cite this article as:
Inoue, K., Nakane, Y., Iiyama, H. et al. Ann Surg Oncol (2002) 9: 27. doi:10.1245/aso.2002.9.1.27

Abstract

Background: The need for a precise lymph node staging without stage migration is of paramount importance when comparing and evaluating international treatment results.

Methods: We reviewed 1019 patients who underwent R0 resection at Kansai Medical University between 1980 and 1997. The patients were classified according to the 1997 International Union Against Cancer (UICC)/American Joint Committee on Cancer (AJCC) pN classification or the N staging depending on the ratio between the number of excised and the number of involved lymph nodes (pN1, ≤25%; pN2, ≤50%; pN3, >50%).

Results: Among the 1997 UICC/AJCC pN subgroups, prognosis worsened with an increase in lymph node ratio. In contrast, the ratio-based classification showed more homogenous survival according to the number of involved lymph nodes. Multiple stepwise regression analysis showed that the ratio-based classification was the most significant prognostic factor, whereas the 1997 UICC/AJCC classification was not found to be an independent predictor of survival. In addition, the ratio-based classification showed a superiority to the 1997 UICC/AJCC classification with respect to stage migration.

Conclusions: Ratio-based lymph node staging is simple and gives more precise information for prognosis with fewer problems related to stage migration than the 1997 UICC/AJCC staging system.

Key Words:

Gastric carcinomaLymph node classificationLymph node metastasisPrognostic factorTNM classificationLymph node ratio

Copyright information

© The Society of Surgical Oncology, Inc. 2002