Moving from Lymph Node Metastasis In Gastric Cancer to Biological Markers: Reply to Letter

Excerpt

Lymph node metastasis (pN category) and tumor depth invasion (pT category) have been the most important prognostic factors for patients with gastric cancer. In the pN category, although several studies [1‐7] have clarified the prognostic significance of the metastatic lymph node ratio (MLR) in gastric cancer, it has not been widely used in clinical practice compared with the UICC/AJCC system commonly used in Western countries and the JGCA system commonly used in Japan. The MLR system has the advantage that it is independent of the number of dissected lymph nodes, which may be affected by the surgeon’s attitude toward lymph node dissection. Moreover, it is simple, convenient, and reproducible for predicting the prognosis as well as for treatment planning. Our study also revealed the superiority of the MLR for evaluating lymph node metastasis in patients with gastric cancer compared with the UICC/AJCC and JGCA systems, although the sample size of the study was small (n = 186). …