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Journal of Gastrointestinal Surgery

, Volume 19, Issue 5, pp 813–820 | Cite as

Usefulness of the Log Odds of Positive Lymph Nodes to Predict and Discriminate Prognosis in Gastric Carcinomas

  • A. CaleroEmail author
  • J. Escrig-Sos
  • F. Mingol
  • A. Arroyo
  • D. Martinez-Ramos
  • M. de Juan
  • J. L. Salvador-Sanchis
  • E. Garcia-Granero
  • R. Calpena
  • F. J. Lacueva
Original Article

Abstract

Background

The lymph node ratio (LNR) and log odds of positive lymph nodes (LODDS) have been proposed to minimize the stage migration phenomenon. The value of the LODDS and LNR staging systems to predict and discriminate prognosis was assessed and compared to the International Union Against Cancer (UICC) TNM classification (pN).

Methods

Three hundred and twenty-six patients with gastric carcinoma were retrospectively studied. Disease-specific survival rates were calculated for every pN, LNR, and LODDS category.

Results

Four LNR categories (0, 1–25, 26–75, and >76 %) and four LODDS categories (−5 to −3, > −3 to −1, > −1 to 3, and >3 to 5) were established. In the multivariate analysis, only the stage pT3-4 versus pT1-2 (HR 1.88, 95 % CI 1.11–3.20, p = 0.02) and LODDS as continuous variable (HR 1.40, 95 % CI 1.21–1.61, p < 0.001) remained as independent prognostic factors. In patients with <16 lymph nodes retrieved, only the LODDS system could discriminate different disease-specific survival curves for every category. LODDS categories were able to discriminate subgroups with different prognoses in pN stages and LNR categories.

Conclusions

The LODDS staging system was superior to the pN classification and LNR system to discriminate risk prognosis especially in patients with an insufficient number of retrieved lymph nodes.

Keywords

Gastric cancer Lymph nodes Lymph node ratio LODDS Prognosis 

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Copyright information

© The Society for Surgery of the Alimentary Tract 2015

Authors and Affiliations

  • A. Calero
    • 1
    Email author
  • J. Escrig-Sos
    • 2
  • F. Mingol
    • 3
  • A. Arroyo
    • 1
  • D. Martinez-Ramos
    • 2
  • M. de Juan
    • 3
  • J. L. Salvador-Sanchis
    • 2
  • E. Garcia-Granero
    • 3
  • R. Calpena
    • 1
  • F. J. Lacueva
    • 1
  1. 1.Department of General and Digestive SurgeryHospital General UniversitarioElcheSpain
  2. 2.Department of General and Digestive SurgeryHospital General UniversitarioCastelló de la PlanaSpain
  3. 3.Department of General and Digestive SurgeryHospital Universitario y Politecnico La FeValenciaSpain

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