The impact of N-ratio in minimizing stage migration phenomenon in gastric cancer patients with insufficient number or level of lymph node retrieved: Results from a Chinese mono-institutional study in 2159 patients

Annals of Oncology

Volumn 20, Issue 5, 2009, Pages 897-905

  Sun, Z ^a   Zhu, G L ^a   Lu, C ^a   Guo, P T ^a   Huang, B J ^a   Li, K ^a   Xu, Y ^a   Li, De Ming ^a   Wang, Z N ^a   Xu, H M ^a  

^a CHINA MEDICAL UNIVERSITY   (China)

Author keywords

Gastric cancer; Lymph node metastasis; Metastatic lymph node ratio; Prognosis; Stage migration

Indexed keywords

ARTICLE; CANCER PATIENT; CANCER STAGING; CHINESE; HUMAN; LYMPH NODE METASTASIS; MAJOR CLINICAL STUDY; OVERALL SURVIVAL; PRIORITY JOURNAL; STOMACH CANCER; SURVIVAL RATE;

CHINA; GASTRECTOMY; HUMANS; KAPLAN-MEIERS ESTIMATE; LYMPH NODE EXCISION; NEOPLASM STAGING; PREDICTIVE VALUE OF TESTS; PROPORTIONAL HAZARDS MODELS; PROSPECTIVE STUDIES; RISK ASSESSMENT; STOMACH NEOPLASMS; TIME FACTORS; TREATMENT OUTCOME;

EID: 65549134794     PISSN: 09237534     EISSN: 15698041     Source Type: Journal    
DOI: 10.1093/annonc/mdn707     Document Type: Article

References (26)

1. Siewert JR, Bittcher K, Stein HJ et al. Relevant prognostic factors in gastric cancer: Ten-year results of the German Gastric Cancer Study. Ann Surg 1998; 228: 449-461.
2. Hohenberger P, Gretschel S. Gastric cancer. Lancet 2003; 362: 305-315.
3. Dicken BJ, Bigam DL, Cass C et al. Gastric adenocarcinoma: Review and considerations for future directions. Ann Surg 2005; 241: 27-39.
4. Kim JP, Lee JH, Kim SJ et al. Clinicopathologic characteristics and prognostic factors in 10,783 patients with gastric cancer. Gastric Cancer 1998; 1: 125-133.
5. Greene FL, Page DL, Fleming ID et al. AJCC Cancer Staging Manual, 6th ed. New York: Springer-Verlag 2002.
6. Japanese Gastric Cancer Association. Japanese classification for gastric cancer: 2nd English edition. Gastric Cancer 1998; 1: 10-24.
7. de Manzoni G, Verlato G, Roviello F et al. The new TNM classification of lymph node metastasis minimises stage migration problems in gastric cancer patients. Br J Cancer 2002; 87: 171-174.
8. Bando E, Yonemura Y, Taniguchi K et al. Outcome of ratio of lymph node metastasis in gastric carcinoma. Ann Surg Oncol 2002; 9: 775-784.
9. Inoue K, Nakane Y, Iiyama H et al. The superiority of ratio-based lymph node staging in gastric carcinoma. Ann Surg Oncol 2002; 9: 27-34.
10. Feinstein AR, Sosin DM, Wells CK. The Will Rogers phenomenon. Stage migration and new diagnostic techniques as a source of misleading statistics for survival in cancer. N Engl J Med 1985; 312: 1604-1608.
11. Karpeh MS, Leon L, Klimstra D et al. Lymph node staging in gastric cancer: Is location more important than number? An analysis of 1,038 patients. Ann Surg 2000; 232: 362-371.
12. Wu CW, Hsiung CA, Lo SS et al. Stage migration influences on stage-specific survival comparison between D1 and D3 gastric cancer surgeries. Eur J Surg Oncol 2005; 31: 153-157.
13. Celen O, Yildirim E, Berberoglu U. Prognostic impact of positive lymph node ratio in gastric carcinoma. J Surg Oncol 2007; 96: 95-101.
14. Persiani R, Rausei S, Biondi A et al. Ratio of metastatic lymph nodes: impact on staging and survival of gastric cancer. Eur J Surg Oncol 2007; 10: 1-6.
15. Kunisaki C, Shimada H, Nomura M et al. Clinical impact of metastatic lymph node ratio in advanced gastric cancer. Anticancer Res 2005; 25: 1369-1376.
16. Cheong JH, Hyung WJ, Shen JG et al. The N ratio predicts recurrence and poor prognosis in patients with node-positive early gastric cancer. Ann Surg Oncol 2006; 13: 377-385.
17. Santiago JMR, Munoz E, Marti M et al. Metastatic lymph node ratio as a prognostic factor in gastric cancer. Eur J Surg Oncol 2005; 31: 59-66.
18. Ichikura T, Ogawa T, Chochi K et al. Minimum number of lymph nodes that should be examined for the International Union Against Cancer/American Joint Committee on Cancer TNM classification of gastric carcinoma. World J Surg 2003; 27: 330-333.
19. Carboni F, Lepiane P, Santoro R et al. Extended multiorgan resection for T4 gastric carcinoma: 25-year experience. J Surg Oncol 2005; 90: 95-100.
20. Dhar DK, Kubota H, Tachibana M et al. Prognosis of T4 gastric carcinoma patients: An appraisal of aggressive surgical treatment. J Surg Oncol 2001; 76: 278-282.
21. Shen JY, Kim S, Cheong JH et al. The impact of total retrieved lymph nodes on staging and survival of patients with pT3 gastric cancer. Cancer 2007; 110: 745-751.
22. Hayashi H, Ochiai T, Suzuki T et al. Superiority of a new UICC-TNM staging system for gastric carcinoma. Surgery 2000; 127: 129-135.
23. D'Ugo D, Pacelli F, Persiani R et al. Impact of the latest TNM classification for gastric cancer: Retrospective analysis on 94 D2 gastrectomies. World J Surg 2002; 26: 672-677.
24. Sasako M, Sano T, Yamamoto S et al. D2 lymphadenectomy alone or with paraaortic nodal dissection for gastric cancer. N Engl J Med 2008; 359: 453-462.
25. Klein KE, Hermans J, van Krieken JH et al. Evaluation of the 5th edition of the TNM classification for gastric cancer: Improved prognostic value. Br J Cancer 2001; 84: 64-71.
26. Marchet A, Mocellin S, Ambrosi A et al. The ratio between metastatic and examined lymph nodes (N ratio) is an independent prognostic factor in gastric cancer regardless of the type of lymphadenectomy: Results from an Italian multicentric study in 1853 patients. Ann Surg 2007; 245: 543-552.