Mu-xing Li¹, Hong Zhao², Xin-yu Bi², Zhen Huang², Zhi-yu Li², Yue Han², Jian-guo Zhou², Ye-fan Zhang², Jian-jun Zhao², Jian-qiang Cai²

 ¹Department of Abdominal Surgical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, ²Chinese Academy of Medical Sciences, Cancer Hospital

Objective:The purpose of this study was to evaluate the prognostic value of lymph node ratio (LNR) in gastric cancer liver metastases patients who received combined surgical resection. Method: A retrospective review of 22 patients with synchronous gastric cancer liver metastases who underwent combined resection in our institute from 2009 to 2013 was conducted. Patients were dichotomized into two groups (low LNR and high LNR) by means of their median LNR. The overall survival (OS) and disease-free survival (DFS) were analyzed by the Kaplan–Meier method, and differences were evaluated by the log-rank test.; Cox proportional hazard model was used to carry out the subsequent multivariate analyses. Result: The median value of LNR was 0.347 (range 0-1). With a median follow-up of 44 months (range 15-69 months), patients with high LNR had significantly shorter OS (median: 15 months vs. 31 months, P=0.034) and DFS (median: 8 months vs. 24 months, P=0.012) compared with those with low LNR. In the multivariate analyses, higher LNR (OS: hazard ratio (HR)=3.210, 95% confidence interval (CI) 1.168-8.823, P=0.024; DFS: HR=4.087, 95% CI 1.453-11.495, P=0.008) and multiple liver metastatic tumors (OS: HR=3.612, 95% CI 1.213-10.751, P=0.021; DFS: HR=2.797, 95% CI 1.114-7.022, P=0.028) were identified as the independent risk factors for both inferior OS and DFS. Conclusion: LNR may be prognostic indicator for predicting the outcome of patients with gastric cancer liver metastases treated by synchronous surgical resection. Further prospective studies with larger sample size and well study design are warranted.

Key Words: lymph node ratio  gastric cancer liver metastases