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Metastatic Lymph Node Ratio: A New Staging System for Gastric Cancer

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Abstract

Background

This study was designed to analyze the prognostic significance of the staging system based on the ratio of metastatic lymph nodes (TRM) compared with the TNM staging system in patients with gastric cancer.

Methods

We reviewed the data of 219 patients who underwent gastrectomy for node-positive M0 cancer. Node Ratio (NR) categories (NR1: 1–15%; NR2: 16–40%; NR3: >40%) were determined by the best cutoff approach at log-rank test. After confirming the prognostic validity of NR in a collinearity-free Cox regression analysis, among different combinations of pT and NR categories we selected five prognostically homogeneous TRM classes. To compare the prognostic power of the TRM vs. TNM systems, we plotted TRM and TNM classes against the mortality estimates.

Results

Both of the TRM and TNM classifications significantly stratified patients outcomes (p < 0.0001), but the TRM system identified prognostic subgroups more homogeneous than the TNM system.

Conclusions

The TRM staging system is a simple and reliable tool to stratify patients with gastric cancer and has a higher prognostic power than the current system.

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Authors and Affiliations

  1. 1st General Surgery Unit, Department of Surgery, Catholic University, Largo A. Gemelli 8, 00168, Rome, Italy

    Roberto Persiani, Stefano Rausei, Alberto Biondi, Francesco Casella & Domenico D’Ugo

  2. General Surgery Unit, General Hospital of Ragusa, Ragusa, Italy

    Vincenzo Antonacci & Luigi Ciccoritti

Authors
  1. Roberto Persiani
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  2. Stefano Rausei
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  3. Vincenzo Antonacci
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  4. Alberto Biondi
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  5. Francesco Casella
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  6. Luigi Ciccoritti
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  7. Domenico D’Ugo
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Corresponding author

Correspondence to Alberto Biondi.

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Persiani, R., Rausei, S., Antonacci, V. et al. Metastatic Lymph Node Ratio: A New Staging System for Gastric Cancer. World J Surg 33, 2106–2111 (2009). https://doi.org/10.1007/s00268-009-0157-5

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  • DOI: https://doi.org/10.1007/s00268-009-0157-5

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