Prognostic impact of positive lymph node ratio in gastric carcinoma

Background and objectives: To evaluate the prognostic value of metastatic lymph node ratio in gastric carcinoma. Methods: One hundred and sixty four patients who underwent D-2 dissection for gastric carcinoma at Ankara Oncology Hospital were reviewed retrospectively. The prognostic factors including Japanese classification, AJCC/UICC TNM classification and metastatic lymph node ratio (1-10% and > 10%) were evaluated in univariate and multivariate Cox regression analysis. Results: The multivariate analysis showed that Borrmann classification, pN-category of AJCC/UICC classification and metastatic lymph node ratio were the most significant prognostic factors and a higher hazard ratio was obtained for metastatic lymph node ratio than pN category of AJCC/UICC classification (4.5 vs. 11.4). When the metastatic ratio groups of 1-10% and > 10% were subdivided into pN(1), pN(2) and pN(3) categories of the AJCC/UICC classification, there was no statistical difference between survival curves. When pN(1), pN(2) and pN(3) categories of the AJCC/UICC classification were subdivided into the ratio groups of 1-10% and > 10%, the survival rate of ratio group 1-10% was better than ratio group > 10%. Conclusion: With its simplicity and reproducibility, metastatic lymph node ratio can be used as a reliable prognostic indicator.