Prognostic and Clinical Significance of the Positive Lymph Node Ratio in Patients Undergoing Radical Resection for Gastric Cancer.

Mortality in patients with gastric cancer (GC) remains high. Therefore, accurate postoperative staging is particularly important for follow-up/treatment and prognostic fate of these patients. In this single-centre study, we analysed retrospective data from 170 consecutive patients with histologically confirmed GC who underwent radical resection. The objective of this observational, retrospective cohort study was, therefore, to evaluate prognostic value of the positive-to-total lymph node ratio (PLNR) and log odds of positive lymph nodes (LODDS), in addition to known predictors of survival, such as TNM staging, grading and histopathological subtypes of GC. All clinically relevant variables (including patient demographics) were initially assessed evaluated as candidate predictors of overall survival (OS) in univariable regression analysis. The final prognostic model for overall mortality included five clinical factors predictive of OS. PLNR was statistically significant associated with 3-year survival (Cramér's  = 0.429, eta = 0.178;  < 0.001). After adjusting for age, sex and disease stage, PLNR remained an independent predictor of mortality ( = 0.016; OR 1.230; 95% CI 1.039-1.455). We have found that the increased PLNR is associated with poor 3-year survival in patients with GC who underwent radical/curative resection. Inclusion of PLNR produced a model of better fit and increased its predictive power for the survival outcome of GC patients.