ObjectiveTo explore the predictive value of metastatic lymph node ratio (MLNR) on prognosis of patients with gastric cancer after radical gastrectomy, and to evaluate whether MLNR can be used as a reference tool to guide the formulation of postoperative adjuvant treatment strategies and prognosis prediction of gastric cancer.MethodsThe clinicopathologic features of patients who underwent D2 radical gastrectomy from January 2014 to December 2017 were retrospectively analyzed. The factors influencing the disease specific survival of gastric cancer were analyzed by Cox proportional hazards model, then the variables with statistical significance in multivariate analysis were included in the construction of nomograms model for prognosis of patients with gastric cancer.ResultsA total of 262 patients with gastric cancer were included. There was no correlation between MLNR and total number of lymph nodes (rs=0.037, P=0.547), there was a positive correlation between MLNR and pN stage (rs=0.909, P<0.001). Multivariate Cox regression analysis showed that pT stage, pN stage, MLNR, and postoperative chemotherapy were the independent predictors of prognosis of gastric cancer after radical gastrectomy. Four variables including pT stage, pN stage, postoperative chemotherapy, and MLNR were included in the construction of nomogram model, the C index of MLNR and pN stage model was 0.707 and 0.692 respectively. Survival analysis showed that the higher the MLNR, the worse the prognosis.ConclusionsThe ability of MLNR to predict prognosis of gastric cancer might be better than pN stage. Therefore, it is considered that MLNR could be used as an important evaluation tool to guide adjuvant treatment and prognosis prediction after radical gastrectomy.
ObjectiveTo investigate the relationship between metastatic lymph node ratio (MLNR) and prognosis of patients after radical resection of distal gastric cancer.MethodsWe retrospectively analyzed the clinicopathological data of 408 patients undergoing radical resection of distal gastric cancer (D2 or D2+ lymph node dissection) in Department of Gastrointestinal Surgery in the Affiliated Hospital of Southwest Medical University, from January 2010 to January 2014. Then we explored the influence of MLNR on the prognosis after radical resection of distal gastric cancer.ResultsWithout distinguishing pTNM staging, the overall survival situation of patient with MLNR≥0.15 and patient with MLNR<0.15 was statistically significant (χ2=3.775, P=0.046); when patients with staging of pTNM Ⅰ, there was no statistically significant MLNR could be calculated; when patients with staging of pTNM Ⅱ, the overall survival situation of patient with MLNR≥0.14 and patient with MLNR<0.14 was statistically significant (χ2=3.110, P=0.029); when patients with staging of pTNM Ⅲ, the overall survival situation of patient with MLNR≥0.10 and patient with MLNR<0.10 was statistically significant (χ2=1.631, P=0.004). Multivariate analysis showed that depth of invasion (pT stage) and MLNR were independent prognostic factors for prognosis of patients after radical resection of distal gastric cancer (P<0.05).ConclusionMLNR is a good prognostic indicator for patients with distal gastric cancer after radical resection.
Objective To explore the clinical features, treatment methods and prognostic factors of primary appendiceal tumors. Methods The clinicopathologic data of 82 patients with primary appendiceal tumor who met the inclusion and exclusion criteria and were treated in the Affiliated Hospital of Southwest Medical University from January 2013 to November 2022 were retrospectively collected, and the clinicopathologic characteristics of the patients were summarized. Log-rank and Cox proportional hazard regression models were further used for univariate and multivariate survival analysis for patients without other malignant tumors. Results Among the 82 patients with primary appendiceal tumor, 9 cases (11.0%) were complicated with other malignant tumors. Low-grade mucinous tumors were the most common (51.2%, 42/82), 25 cases were complicated with appendicitis and 12 cases were complicated with intestinal obstruction. Common clinical manifestations included abdominal pain, changes in bowel habits, abdominal distension, vomiting, nausea, etc. Among the patients without other malignancies, 69 patients were followed up for a median of 32 months (4–106 months), 18 of whom died. The 1-year, 2-year, 3-year and 5-year cumulative survival rates were 91.1%, 87.5%, 80.5% and 60.7%, respectively. Multivariate Cox proportional hazard regression analysis showed that platelet-to-lymphocyte ratio (P=0.004), anemia (P=0.015), tumor metastasis (P=0.007) and diabetes mellitus (P=0.011) were prognostic factors. Among them, patients with platelet-to-lymphocyte ratio >190.1, anemia, tumor metastasis and diabetes mellitus had poor prognosis. Conclusions The main pathological type of primary appendiceal tumors is low grade mucinous tumors. It lacks characteristic clinical manifestations, with abdominal pain and changes in bowel habits as the main manifestations, and can be accompanied by appendicitis and intestinal obstruction. There is no unified standard for treatment. For patients characterized by prognostic risk factors including platelet-to-lymphocyte ratio >190.1, anemia, tumor metastasis and diabetes, further monitoring and intervention are required.