The metastatic lymph node ratio is a better prognostic factor than the number of metastatic limph node after curative resection for gastric cancer.

AIM: Evaluate impact of lymph node ratio as prognostic factor in gastric cancer. METHODS: We studied 463 patients with gastric cancer who underwent curative gastric surgery with D1 or D2 lymphadenectomy, Data were collected from May 1996 through December 2010 at Department of General Surgery of Parma University Hospital. We divided patients in two groups according to number of nodes removed Results: The results of the present nonrandomized retrospective single centre study confirm the promising role of the LNR as an independent prognostic factor. Overall survival between LNR categories are statistically significant different between LNR0 and LNR1. CONCLUSION: The ratio between the number of metastatic and analysed lymph nodes in patients with gastric cancer can discriminate patients better than the AJCC/UICC staging system: it seems to be related to a more sensitive in the evaluation of overall survival.

Experience of 463 cases of gastric cancer from a single surgical center.

AIM: To evaluate clinical and histopathological changes of gastric cancer (GC) in the last fifteen years and analyze factors influencing overall survival. MATERIAL OF STUDY: We have retrospectively categorized patients submitted to surgery for GC from January 1996 to December 2010. The analysis focused on two periods: 1996-2003 (period 1) and 2004-2010 (period 2). RESULTS: There was an increase in age distribution of GC in period 2 (p=0.012). Significant increase of whole GC was observed in period 2 (p=0.01). Slight but significant changes in TNM stage were found: in group 2 there was a decrease in the rate of early GC and in advanced depth of tumor invasion; increase of lymph nodes involvement was also demonstrated. Overall survival (OS) had not changed from the first to the second period. There was a significant difference in OS calculated for Lauren histotype: from ten months to surgery, patients with diffuse histotype showed worse prognosis. DISCUSSION: The most important findings were an increase in lymph node involvement and a decrease in depth of tumor invasion, an higher percentage of whole type and a decrease in palliative surgery. Overall-survival hasn't change in the last fifteen years. These results confirms the importance of extent of lymph node dissection in the standard surgical approach of GC, the tumor stage and Lauren histotypes as the main prognostic factors in GC. CONCLUSION: This work confirms the dismal prognosis of GC and the need to increase diagnosis of early gastric cancer. KEY WORDS: Gastric cancer, Lauren histotype, Overall survivall.