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. J. Surg. Oncol. 2007;96:95–101. © 2007 Wiley‐Liss, Inc.