| Objective To compare the prognostic value of four lymph node staging strategies, including the number of metastatic lymph nodes (pN), metastastic lymph nodes ratio(MLR), negative lymph node count(NLNC) and log odds of positive lymph nodes (LODDS), in advanced gastric cancer patients.Methods Retrospective analysis was performed on the clinical data of 241 patients with advanced gastric cancer who underwent radical gastrectomy in the Provincial Hospital of Anhui Medical University from June 2010 to May 2013. All 241 patients were grouped according to the grouping criteria of pN, MLR, NLNC, and LODDS lymph node staging methods. Patients were compared in groups with pN, MLR, NL NC, LODDS lymph node staging methods in terms of the difference in 5-year survival rate, using Kaplan-Merier survival analysis for univariate analysis, Log-rank comparison between groups. The Cox proportional hazard model was used to compare the correlations between the four lymph node staging methodsof pN, MLR, NLNC and LODDS and the prognosis of patients, and the evaluation value of the four methods was judged. Results The 5-year survival rates of patients with advanced gastric cancer were significantly different according to four different lymph node staging methods:pN (P<0.05), MLR (P<0.05), NLNC (P<0.05), and LODDS (P<0.05). Univariate analysis showed that the factors affecting the prognosis of patients with advanced gastric cancer included age, surgical approach, tumor location, tumor size, depth of tumor invasion (Tx), gross classification, differentiation type, and total lymph node dissection. Cox multivariate analysis showed that likelihood ratios of Δχ2 for pN, MLR, NLNC, and LODDS were 3.539, 7.812, 14.780, and 6.161. Obviously, the MLR, NLNC, and LODDS stages were higher than the pN stage, and NLNC corresponding likelihood ratio of Δχ2 was the highest. Conclusion Compared with pN staging methods, MLR, NLNC, and LODDS staging methods, especially NLNC, have better prognostic evaluation value. |
