Metastatic Lymph Node Ratio as a Prognostic Factor in Gastric Adenocarcinoma

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Objective: Gastric cancer remains an important health problem.Although the classical staging system is the tumor, node, metastasis (TNM) system, stage migration phenomenon may occur depending on the number of lymph nodes removed.Therefore, although there are opinions that lymph node metastasis rate can be used as an alternative to TNM, a clear cut-off value has not been determined.In our study, we aimed to evaluate the survival in TNM staging according to the metastatic lymph node rate.Methods: Patients operated for gastric adenocarcinoma between 2015 and 2022 were evaluated retrospectively.Patients were divided into quartiles according to the metastatic lymph node rate.Mean survival times were compared between the two groups according to TNM stages and metastatic lymph node rate.Results: One hundred ninety-nine patients were included in the study.When survival was evaluated, it was observed that survival decreased with increasing disease stage and metastatic lymph node ratio.All patients with stage 1 and 2 were in the 1 st quartile (25%) according to metastatic lymph node ratio.In the evaluation of stage 3 patients, it was seen that survival decreased as the metastatic lymph node ratio increased.Conclusion: Our study revealed that metastatic lymph node ratio of 25% and above is an important parameter in predicting prognosis.Especially in stage 3 patients, metastatic lymph node ratio was shown to be a valuable parameter in predicting survival.

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