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Background <p>Adequate lymph node (LN) retrieval during D2-gastrectomy is critical for staging accuracy in gastric cancer. Debate continues regarding the prognostic value of absolute LN yield versus other nodal parameters such as LN positivity ratio and nodal stage.</p> Methods <p>A retrospective analysis of 70 patients undergoing D2-gastrectomy from 2019 to 2024 evaluated associations of LN yield, LN ratio, nodal stage, and surgery timing with mortality. Statistical tests included Fisher’s exact test and Mann–Whitney U.</p> Results <p>LN yield (&lt; 30 vs. ≥ 30) was not associated with mortality (<i>p</i> = 0.628). LN ratio and nodal stage were significantly associated with mortality (<i>p</i> &lt; 0.05). Multivariate analysis did not identify independent predictors, likely due to collinearity among nodal variables.</p> Conclusion <p>LN positivity ratio and nodal stage outperform total LN yield as predictors of overall mortality. Incorporating LN ratio into staging systems may improve prognostic stratification.</p>

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Predictors of Overall Mortality Following D2-Gastrectomy for Gastric Cancer: A Retrospective Cohort Study

  • 期刊论文

  • 发表日期：

    2026年5月6日

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  • Sureshkumar D.,
  • Bharanidharan T.,
  • Rajeswaran A.,
  • Gokul Kumaran S.

摘要

Background

Adequate lymph node (LN) retrieval during D2-gastrectomy is critical for staging accuracy in gastric cancer. Debate continues regarding the prognostic value of absolute LN yield versus other nodal parameters such as LN positivity ratio and nodal stage.

Methods

A retrospective analysis of 70 patients undergoing D2-gastrectomy from 2019 to 2024 evaluated associations of LN yield, LN ratio, nodal stage, and surgery timing with mortality. Statistical tests included Fisher’s exact test and Mann–Whitney U.

Results

LN yield (< 30 vs. ≥ 30) was not associated with mortality (p = 0.628). LN ratio and nodal stage were significantly associated with mortality (p < 0.05). Multivariate analysis did not identify independent predictors, likely due to collinearity among nodal variables.

Conclusion

LN positivity ratio and nodal stage outperform total LN yield as predictors of overall mortality. Incorporating LN ratio into staging systems may improve prognostic stratification.