Clinicopathologic implication of meticulous pathologic examination of regional lymph nodes in gastric cancer patients

edition, metastatic LN ratio (MLR), and log odds of positive LNs (LODDS).Four cohorts with a total of 2,309 gastric cancer patients were enrolled. For cohort 1 and 2, prognostic significance of each method by disease-specific survival was analyzed using Akaike and Bayesian information criterion (AIC and BIC).The total LNs in four cohorts significantly differed [median (range), 28 (6–97) in cohort 1, 37 (8–120) in cohort 2, 48 (7–122) in cohort 3, and 54 (4–221) in cohort 4; p<0.001]. The numbers of negative LNs increased with increase of total LN (p<0.001), but the numbers of metastatic LNs did not increase from cohort 1 to 4. MLR and LODDS in four cohorts had decreasing tendency with increase of total LNs in each pT3 and pT4 category (p<0.001), while the numbers of metastatic LNs did not differ significantly in any pT category (p>0.05). The AIC and BIC varied according to different cut-off values for MLR; model by cut-offs of 0.2 and 0.5 being better for cohort 1, while cut-offs 0.1 and 0.25 was better for cohort 2. system is suggested as the simplest method with single cut-off value, but prognostic significance of MLR may be influenced by various cut-offs