Introduction

The aim of this study was to clarify the prognostic value of the pathological lymph node ratio for older adult and younger adult gastric cancer patients and to evaluate whether there is a difference in the survival of patients with the same lymph node ratio (LNR).

Materials and Methods

A total of 222 patients diagnosed with locally advanced gastric cancer who underwent upfront gastrectomy without neoadjuvant chemotherapy and had negative surgical margins were included. The patients were divided into two groups according to age. Clinicopathological properties of the two groups were compared. Potential prognostic factors affecting survival were analyzed. Subsequently, the effect of lymphadenectomy and LNR on survival in both groups was evaluated.

Results

Thirty patients with perioperative mortality were excluded and 192 patients were analyzed. Significant differences were detected in terms of hemoglobin and albumin levels between older adult patients and younger adult patients (p < 0.05). Overall survival (OS) was significantly worse in older adult patients (22 months vs. 67 months, p < 0.001). The survival rates in older adult patients were significantly lower from those of younger adult in the subgroup LNR Stage 2 (12.1% vs. 47.9%, p = 0.004) and LNR Stage 3 classification (9.1% vs. 34.1%, p = 0.039). LNR was found to be significant for OS with a cut-off point of 0.18.

Discussion

A survival difference was found between the older adult and younger adult patients with the same LNR. LNR was found to be an independent factor for survival especially in older adult patients. Survival was found to be further decreased in older adult patients compared to younger adult patients with increasing LNR.

中文翻译：

---

淋巴结比例相同的老年局部晚期胃癌患者与年轻成人患者的生存率是否存在差异？

介绍

本研究的目的是阐明病理淋巴结比对老年和年轻成人胃癌患者的预后价值，并评估相同淋巴结比 (LNR) 患者的生存率是否存在差异。

材料和方法

共纳入 222 例被诊断为局部晚期胃癌的患者，这些患者在没有新辅助化疗的情况下接受了前期胃切除术，并且手术切缘为阴性。患者根据年龄分为两组。比较两组的临床病理特征。分析了影响生存的潜在预后因素。随后，评估了淋巴结切除术和 LNR 对两组生存率的影响。

结果

排除了 30 例围手术期死亡患者，对 192 例患者进行了分析。老年患者和年轻患者的血红蛋白和白蛋白水平存在显着差异（p < 0.05）。老年患者的总生存期 (OS) 明显更差（22 个月 vs. 67 个月，p < 0.001）。在 LNR 第 2 期（12.1% 对 47.9%，p = 0.004）和 LNR 第 3 期分类（9.1% 对 34.1%，p = 0.039）亚组中，老年患者的存活率明显低于年轻成人. 发现 LNR 对 OS 很重要，截止点为 0.18。

讨论

在具有相同 LNR 的老年人和年轻成人患者之间发现了生存差异。LNR 被发现是生存的独立因素，尤其是在老年患者中。与 LNR 增加的年轻成年患者相比，老年患者的存活率进一步降低。