The N ratio predicts recurrence and poor prognosis in patients with node-positive early gastric cancer

Jae Ho Cheong, WooJin Hyung, Guo Shen Jian, Changsoo Song, Junuk Kim, Ho Choi Seung, Hoon Noh Sung

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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.

Original languageEnglish
Pages (from-to)377-385
Number of pages9
JournalAnnals of Surgical Oncology
Volume13
Issue number3
DOIs
Publication statusPublished - 2006 Mar 1

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Stomach Neoplasms
Recurrence
Neoplasm Metastasis
Multivariate Analysis
Lymph Nodes
Neoplasms
Survival Rate
Databases
Survival

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

Cheong, Jae Ho ; Hyung, WooJin ; Jian, Guo Shen ; Song, Changsoo ; Kim, Junuk ; Seung, Ho Choi ; Sung, Hoon Noh. / The N ratio predicts recurrence and poor prognosis in patients with node-positive early gastric cancer. In: Annals of Surgical Oncology. 2006 ; Vol. 13, No. 3. pp. 377-385.
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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.",
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The N ratio predicts recurrence and poor prognosis in patients with node-positive early gastric cancer. / Cheong, Jae Ho; Hyung, WooJin; Jian, Guo Shen; Song, Changsoo; Kim, Junuk; Seung, Ho Choi; Sung, Hoon Noh.

In: Annals of Surgical Oncology, Vol. 13, No. 3, 01.03.2006, p. 377-385.

Research output: Contribution to journalArticle

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T1 - The N ratio predicts recurrence and poor prognosis in patients with node-positive early gastric cancer

AU - Cheong, Jae Ho

AU - Hyung, WooJin

AU - Jian, Guo Shen

AU - Song, Changsoo

AU - Kim, Junuk

AU - Seung, Ho Choi

AU - Sung, Hoon Noh

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N2 - 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.

AB - 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.

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