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The following is a summary of “Prognostic performance of examined lymph nodes, lymph node ratio, and positive lymph nodes in gastric cancer: a competing risk model study,” published in the February 2025 issue of Frontiers in Endocrinology by Gu ad Du et al. 

Researchers conducted a retrospective study to evaluate the prognostic effectiveness of examined lymph nodes (ELN), lymph node ratio (LNR), and positive lymph nodes (pN) in postoperative gastric cancer (GC).  

They applied a competing risk model (CRM) to assess prognostic markers in 337 individuals with lymph node (LN)-positive stage II GC who underwent resection and chemotherapy from 2010 to 2015 using data from the Surveillance, Epidemiology, and End Results database. Restricted cubic splines identified optimal cutoff values for ELN and LNR, while pN were categorized into 3 groups per the American Joint Committee on Cancer (AJCC) staging system. Survival analyses included Kaplan–Meier curves, Cox proportional hazards analysis, cumulative incidence curves, and CRM. Subgroup analysis and interaction tests examined the correlation between LN status and survival.  

The results showed that the optimal cutoff values were 16 for ELN, 0.1 for LNR, and 2 for pN. Multivariate Cox analysis identified ELN (hazard ratio [HR] = 0.67), LNR (HR = 2.23), and pN (HR = 2.80) as independent predictors of overall survival (OS), while only LNR (HR = 2.08) was independently linked to disease-specific survival. The CRM confirmed independent associations of LNR (sub-distribution hazard ratio [SHR] = 1.89) and pN (SHR = 2.80) with disease-specific survival.  

Investigators concluded that ELN, LNR, and pN all predicted OS in GC; LNR proved a more robust predictor of disease-specific survival than ELN and pN, potentially offering valuable supplemental information to the TNM staging system. 

Source: frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2025.1434999/full