Acar Omer, Balcik Onur Yazdan, Urun Muslih, Avci Tugay, Sahbazlar Mustafa, Erdogan Atike Pinar
Manisa Celal Bayar University, Medical Oncology Department, Manisa, Turkey.
Mardin Training and Research Hospital Medical Oncology, Mardin, Turkey.
Heliyon. 2024 Oct 2;10(19):e38809. doi: 10.1016/j.heliyon.2024.e38809. eCollection 2024 Oct 15.
The pivotal prognostic determinant for recurrence and survival in surgically treated gastric cancer (GC) patients remains the lymph node status. Despite the adoption of D2 lymph node dissection as the standard approach in recent years, its association with increased morbidity in elderly patients raises concerns. This study aims to explore the prognostic significance of the Positive Lymph Node Ratio (PLNR) score in the context of recurrence and survival among elderly patients with surgically treated GC.
A retrospective review of files about surgically treated patients with GC was conducted. The prognostic impact of the PLNR score on overall survival (OS) was assessed through Receiver Operating Characteristic (ROC) analysis.
The cut-off value for the PLNR, determined through ROC analysis, was identified as 0.138. This value serves as a crucial threshold, as it distinguishes patients with a higher risk of poor outcomes. Patients with a PLNR score of 0.138 or below exhibited a median OS of 111 months, whereas those with a PLNR score above 0.138 had a significantly lower median OS of 22 months (p = 0.004).
Our findings revealed that the PLNR emerged as an independent predictor of survival and recurrence in patients undergoing GC resection.However, it's important to note that while valuable, the PLNR system has limitations. It does not encompass the T stage, a key factor in cancer staging. Therefore, it cannot be a direct substitute for the comprehensive information TNM staging provides. It should be used as a supplementary tool in predicting prognosis, particularly in elderly patients unsuitable for standard lymph node dissection.
手术治疗的胃癌（GC）患者复发和生存的关键预后决定因素仍然是淋巴结状态。尽管近年来采用D2淋巴结清扫作为标准方法，但其与老年患者发病率增加的关联引发了担忧。本研究旨在探讨阳性淋巴结比率（PLNR）评分在手术治疗的老年GC患者复发和生存背景下的预后意义。
对手术治疗的GC患者档案进行回顾性研究。通过受试者工作特征（ROC）分析评估PLNR评分对总生存期（OS）的预后影响。
通过ROC分析确定的PLNR临界值为0.138。该值是一个关键阈值，因为它区分了预后不良风险较高的患者。PLNR评分为0.138或更低的患者中位OS为111个月，而PLNR评分高于0.138的患者中位OS显著更低，为22个月（p = 0.004）。
我们的研究结果表明，PLNR是接受GC切除患者生存和复发的独立预测因素。然而，需要注意的是，虽然PLNR系统有价值，但也有局限性。它不包括T分期，而T分期是癌症分期的关键因素。因此，它不能直接替代TNM分期提供的全面信息。它应用作预测预后的辅助工具，特别是在不适合标准淋巴结清扫的老年患者中。
