Predictive value of positive lymph node ratio in patients with locally advanced gastric remnant cancer

Table 1 Baseline characteristics of all patients, n (%)

Variables	Values
Gender
Male	66 (89.2)
Female	8 (10.8)
Age (yr) (mean ± SD, range)	66.24 ± 9.057 (41-86)
Initial surgery
Benign	64 (86.5)
Malignant	10 (13.5)
Interval (yr) (mean ± SD, range)	29.32 ± 11.97 (5-55)
Reconstruction
Billroth I	20 (27.0)
Billroth II	54 (73.0)
Lesion location
Anastomosis site	47 (63.5)
Non-anastomotic	22 (29.7)
Total remnant stomach	5 (6.8)
Histological types
Differentiated	22 (29.7)
Undifferentiated	52 (70.3)
Borrmann
Borrmann I	7 (9.4)
Borrmann II	13 (17.6)
Borrmann III	46 (62.2)
Borrmann IV	8 (10.8)
Vascular or nerve invasion
Yes	33 (44.6)
No	41 (55.4)
Tumor diameter (cm) (mean ± SD, range)	5.59 ± 2.61 (0.50-12.00)
Combine resection
Yes	26 (35.1)
No	48 (64.9)
Hypoproteinemia
Yes	15 (20.3)
No	59 (79.7)
Anemia
Yes	24 (32.4)
No	50 (67.6)
Serum tumor biomarkers level
Normal	47 (63.5)
Abnormal	27 (36.5)
Depth of tumor invasion
T2/T3	13 (17.6)
T4	61 (82.4)
N stage
N0	27 (36.5)
N1	13 (17.6)
N2	18 (24.3)
N3	16 (21.6)
LNR stage
LNR0	27 (36.5)
LNR1	12 (16.2)
LNR2	16 (21.6)
LNR3	19 (25.7)
TNM stage
IB-II	26 (35.1)
III	48 (64.9)

N stage: Lymph node stage; LNR: Lymph node ratio; TNM stage: Tumor-node metastasis stage.

Table 2 Factors correlated with lymph node stage

Variables	N0	N1	N2	N3	F/χ2	P value
Dissected lymph nodes	9.85 ± 7.32	9.15 ± 5.89	9.83 ± 7.56	17.13 ± 8.22	4.294	0.008
Metastatic lymph nodes	0.00 ± 0.00	1.23 ± 0.44	4.06 ± 1.16	11.56 ± 4.77	91.523	0.000
Tumor diameter	3.96 ± 1.67	5.92 ± 2.56	6.83 ± 2.70	6.66 ± 2.64	7.363	0.000
Borrmann					17.450	0.042
Borrmann I	3	0	2	2
Borrmann II	9	0	3	1
Borrmann III	15	12	9	10
Borrmann IV	0	1	4	3
Depth of tumor invasion					11.152	0.011
T2/T3	10	1	1	1
T4	17	12	17	5
Serum tumor biomarkers level					9.019	0.029
Normal	22	9	7	9
Abnormal	5	4	11	7
TNM stage					54.105	0.000
IB-II	24	1	1	0
III	3	12	17	16
Combine resection					8.917	0.030
Yes	4	6	10	6
No	23	7	8	10

N stage: Lymph node stage; TNM stage: Tumor-node metastasis stage.

Table 3 Factors correlated with lymph node ratio stage

Variables	LNR0	LNR1	LNR2	LNR3	F/χ2	P value
Metastatic lymph nodes	0.00 ± 0.00	1.75 ± 1.29	6.63 ± 5.51	7.74 ± 5.12	21.263	0.000
Tumor diameter	3.96 ± 1.67	5.38 ± 2.05	6.66 ± 2.32	7.13 ± 3.01	8.755	0.000
Borrmann					21.878	0.009
Borrmann I	3	0	0	4
Borrmann II	9	1	3	0
Borrmann III	15	10	11	10
Borrmann IV	0	1	2	5
Depth of tumor invasion					12.470	0.006
T2/T3	10	2	0	1
T4	17	10	16	18
Serum tumor biomarkers level					8.654	0.034
Normal	22	6	11	8
Abnormal	5	6	5	11
TNM stage					54.986	0.000
IB-II	24	2	0	0
III	3	10	16	19
Vascular or nerve invasion					8.616	0.035
Yes	8	8	5	2
No	19	4	11	7

LNR: Lymph node ratio; TNM stage: Tumor-node metastasis stage.

Table 4 Prognostic factors of gastric remnant cancer based on univariate log-rank test

Variable	n	Median survival time (months)	P value
Tumor diameter (cm)			0.013
< 5.5	35	48.0
≥ 5.5	39	25.0
Anemia (HGB) < 90 g/L			0.034
Yes	24	23.0
No	50	37.0
Serum tumor biomarkers level			0.014
Normal	47	37.0
Abnormal	27	26.0
Vascular or nerve invasion			0.020
Yes	33	25.0
No	41	43.0
Combined resection			0.021
Yes	26	25.0
No	48	39.0
N stage			0.000
N0	27	61.0
N1	13	31.0
N2	18	19.0
N3	16	20.0
LNR stage			0.000
LNR0	27	61.0
LNR1	12	31.0
LNR2	16	23.0
LNR3	19	17.0
TMN stage			0.000
IB-II	26	79.0
III	48	25.0

HGB: Hemoglobin; N stage: Lymph node stage; LNR: Lymph node ratio; TNM stage: Tumor-node metastasis stage.

Table 5 Prognostic factors of gastric remnant cancer based on COX proportional hazards model

Variable	B	SE	Wald	df	P value	HR	95%CI
LNR stage	0.499	0.122	16.755	1	0.000	1.647	1.297-2.092
Anemia	0.656	0.287	5.216	1	0.022	1.926	1.097-3.381
Serum tumor biomarkers level	0.612	0.293	4.365	1	0.037	1.844	1.039-3.275

B: Beta; SE: Standard error; df: Degree of freedom; HR: Hazard ratio; LNR: Lymph node ratio.