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The N Ratio Predicts Recurrence and Poor Prognosis in Patients With Node-Positive Early Gastric Cancer

Authors
 Jae-Ho Cheong  ;  Woo Jin Hyung  ;  Jian Guo Shen  ;  Changsoo Song  ;  Junuk Kim  ;  Seung Ho Choi  ;  Sung Hoon Noh 
Citation
 ANNALS OF SURGICAL ONCOLOGY, Vol.13(3) : 377-385, 2006 
Journal Title
ANNALS OF SURGICAL ONCOLOGY
ISSN
 1068-9265 
Issue Date
2006
MeSH
Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Lymphatic Metastasis* ; Male ; Middle Aged ; Neoplasm Recurrence, Local* ; Neoplasm Staging/methods* ; Prognosis ; Stomach Neoplasms/pathology* ; Stomach Neoplasms/surgery ; Survival Analysis
Keywords
Early gastric cancer ; Lymph node metastasis ; Metastatic lymph node ratio ; Prognosis Recurrence
Abstract
BACKGROUND: The metastatic status of the regional node is the most significant prognostic factor for early gastric cancer (EGC). However, diverse prognoses are evident even among the same N classifications of the current tumor-node-metastasis system. The aim of this study was to evaluate the prognostic significance of the ratio of metastatic to retrieved lymph nodes (N ratio) in identifying a high-risk subgroup with node-positive EGC. METHODS: From a prospective database of 1264 EGC patients between 1987 and 1997, 156 (12.4%) were found to have histologically confirmed node metastasis. A number of prognostic factors, including the N ratio, were evaluated by univariate and multivariate analysis. RESULTS: The recurrence rate of node-positive EGC was 16.7% (n = 26). The overall 5-year survival rate of all patients was 84.0%. It was 26.9% and 95.4% in patients with and without recurrence, respectively (P < .0001; log-rank test). The cutoff value of the N ratio was set at .07. The 5-year survival rate of patients with an N ratio <.07 was 94.0%; this was significantly higher than the rate (72.6%) for those with a ratio >.07 (P < .0001; log-rank test). Both univariate and multivariate analysis identified the N ratio as the most significant predictive factor for recurrence and overall survival. Regarding stage migration, it shows superiority in comparison to the number-based N classification. CONCLUSIONS: The N ratio is a more effective and rational indicator for prognostic stratification of patients with lymph node-positive EGC than the current N classification of the tumor-node-metastasis system.
Full Text
http://link.springer.com/article/10.1245%2FASO.2006.04.018
DOI
10.1245/ASO.2006.04.018
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Song, Chang Soo(송창수)
Cheong, Jae Ho(정재호) ORCID logo https://orcid.org/0000-0002-1703-1781
Choi, Seung Ho(최승호) ORCID logo https://orcid.org/0000-0002-9872-3594
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/109599
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