The lymph node ratio is a powerful prognostic factor of node-positive XXXX undergoing potentially curative surgery.

@entity1 @entity5 @entity477 @entity3121 @entity694
BACKGROUND: The number of harvested (LNs) and metastatic nodes (LNs+) represents the most significant factor to define postoperative treatment and prognosis in @entity694 . However, its assessment may be inadequate causing an incorrect @entity5 staging. The lymph node ratio (LNR: the ratio between metastatic and resected nodes) has shown prognostic significance in many @entity5 ; however, its role in @entity694 is not clearly elucidated. This study investigated LNR as a prognostic factor in node-positive @entity694 . METHODS: A total of 145 consecutive @entity1 with node-positive @entity694 who underwent curative surgery and adjuvant chemotherapy in a single oncologic unit entered this study. RESULTS: LNR ranged from 0.0416 to 0.9; it was clearly lower in @entity3121 than @entity477 @entity1 , and increased as @entity5 stage worsened. ROC analysis selected 0.1818 as the best LNR cutoff value. Low LNR @entity1 did significantly better than high LNR @entity1 ; this difference was not dependent on the number of LNs and stronger than differences observed by grouping @entity1 according to LNs or LNs+. When stratified by low and high LNR value, @entity3121 and @entity477 @entity1 , as well as stage III subgroups were shown to display substantially different outcomes. LNR was an independent prognostic factor for disease-specific survival, and the only covariate related to disease-free survival. CONCLUSIONS: LNR was a robust prognostic indicator for node-positive @entity694 undergoing curative surgery. Because this ratio-based staging was demonstrated to reduce stage migration and to aid in identifying high-risk @entity1 , it should be proposed as a standard tool for @entity5 .
