Background/aims: This study aimed to investigate the role of metastatic lymph node ratio (MLR) in the evaluation of prognosis of patients with gastric cancer at different T stages.
Methodology: Clinical information was reviewed retrospectively in a total 535 patients who underwent surgery for gastric cancer. The prognostic value of MLR was compared with that of pN determined according to the UICC/AJCC guidelines (7th Edition), and the characteristics and advantages of MLR were analyzed. Moreover, the role of MLR in the evaluation of prognosis of patients with gastric cancer at different pT stages was investigated.
Results: Univariate Kaplan-Meier method was used for the analysis of survival, and the results showed that MLR was closely associated with the prognosis of these patients. Multivariate analysis with Cox proportional hazards regression model showed that MLR was a major independent risk factor in the prognosis of gastric cancer patients. The area under the ROC curve of MLR in predicting the death of gastric cancer patients within 5 years after surgery was not associated with pN stage. MLR was effective in predicting the prognosis of patients with stage pT2 or pT3 gastric cancer (P < 0.05).
Conclusions: MLR is an independent risk factor in the prognosis of gastric cancer. MLR has a prognostic ability comparable to that of pN stage in gastric cancer. Thus, it is more reliable than pN in the evaluation of prognosis of gastric cancer patients, especially those with stage pT2-pT3 gastric cancer.