Sakin Abdullah, Atci Muhammed M, Aldemir Mehmet Naci, Akagündüz Baran, Şahin Suleyman, Arıcı Serdar, Secmeler Saban, Cihan Sener
Medical Oncology, Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, TUR.
Medical Oncology, Yüzüncü Yıl University, Van, TUR.
Cureus. 2021 Apr 22;13(4):e14639. doi: 10.7759/cureus.14639.
Objective In this study, we aimed to investigate the prognostic value of postoperative lymph node ratio (LNR)in locally advanced gastric cancer (GC) patients receiving neoadjuvant chemotherapy (NACT). Methods LNR was calculated as the ratio of positive LNs to the total LNs removed. The receiver operating characteristic (ROC) curve was plotted to estimate the cut-off value of LNR for recurrence. The area under the curve of LNR was 0.714 (95% CI: 0.604-0.825, p<0.001) with 60% sensitivity and >0.255 with 76% specificity. Patients were grouped as group I (≤0.255) and group II (>0.255). Results In this study, 157 GC patients were included (39.5% female and 60.5% male). Of the patients, 97 (61.8%) were in group I and 60 (38.2%) were in group II. Disease‑free survival (DFS) was not reached in group I, and it was 16 months in group II (p<0.001). Overall survival (OS) was 58 months in group I and 28 months in group II (p>0.001). In multivariate analysis, lymphovascular invasion, neoadjuvant response, adjuvant treatment, and LNR were found to be the factors associated with DFS and OS (p<0.05). Conclusion In our study, it was observed that LNR can predict survival rates better than LN staging.
目的 在本研究中，我们旨在探讨术后淋巴结比率（LNR）对接受新辅助化疗（NACT）的局部晚期胃癌（GC）患者的预后价值。方法 LNR计算为阳性淋巴结数与切除的总淋巴结数之比。绘制受试者工作特征（ROC）曲线以估计LNR用于复发的临界值。LNR的曲线下面积为0.714（95%CI：0.604 - 0.825，p<0.001），敏感性为60%，特异性>0.255时为76%。患者分为I组（≤0.255）和II组（>0.255）。结果 本研究纳入了157例GC患者（女性占39.5%，男性占60.5%）。其中，97例（61.8%）在I组，60例（38.2%）在II组。I组无病生存期（DFS）未达到，II组为16个月（p<0.001）。I组总生存期（OS）为58个月，II组为28个月（p>0.001）。多因素分析发现，淋巴管侵犯、新辅助治疗反应、辅助治疗和LNR是与DFS和OS相关的因素（p<0.05）。结论 在我们的研究中，观察到LNR比淋巴结分期能更好地预测生存率。
