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

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Journal of Gastrointestinal Surgery Aims and scope

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.

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Authors and Affiliations

  1. Department of Surgery, Gastroenterological Center, Yokohama City University Graduate School of Medicine, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan

    Chikara Kunisaki & Hirochika Makino

  2. Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan

    Chikara Kunisaki, Hirochika Makino, Hirotoshi Akiyama, Yuichi Otsuka, Hidetaka A. Ono, Takashi Kosaka, Ryo Takagawa & Hiroshi Shimada

  3. Department of Surgery, Yokosuka Kyosai Hospital, 1-16, Yonegahama-dori, Yokosuka, 238-0001, Japan

    Yutaka Nagahori

  4. Department of Surgery, Yokohama Municipal Hospital, 56 Okazawa-cho, Hodogaya-ku, 240-0062, Japan

    Masazumi Takahashi & Fumihiko Kito

Authors
  1. Chikara Kunisaki
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  2. Hirochika Makino
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  3. Hirotoshi Akiyama
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  4. Yuichi Otsuka
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  5. Hidetaka A. Ono
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  6. Takashi Kosaka
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  7. Ryo Takagawa
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  8. Yutaka Nagahori
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  9. Masazumi Takahashi
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  10. Fumihiko Kito
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  11. Hiroshi Shimada
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Correspondence to Chikara Kunisaki.

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Kunisaki, C., Makino, H., Akiyama, H. et al. Clinical Significance of the Metastatic Lymph-Node Ratio in Early Gastric Cancer. J Gastrointest Surg 12, 542–549 (2008). https://doi.org/10.1007/s11605-007-0239-3

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  • DOI: https://doi.org/10.1007/s11605-007-0239-3

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