Predictive Factors for Lymph Node Metastasis and the Effect on Survival in Early Gastric Cancer Patients with Radical Gastric Resection

Can the Combination of Magnetic Resonance Imaging, Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Predict the Mass Origin in Ovarian Masses?

Objective

Evaluate the effectiveness of magnetic resonance imaging (MRI), blood parameters, and tumor markers to determine the role of objective criteria in distinguishing malignant, borderline, and benign masses and to minimize unnecessary surgical interventions by reducing interpretation differences.

Methods

The histopathological and clinical-laboratory results of the patients who underwent surgery for the initial diagnosis and whose ovarian masses were confirmed were retrospectively reviewed. Between groups, age, cancer antigen 125, mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), the presence of ascites, the ovarian-adnexal reporting and data system MRI scores, mass characteristics, and lymphocyte count were compared.

Results

The study comprised a total of 191 patients. These patients were categorized into three groups: Benign (n=113), borderline (n=26), and malignant (n=52). No noteworthy correlation was detected between the unilocular or multilocular nature of solid, cystic, or mixed masses and the rates of NLR, PLR, or MPV. However, a notable correlation was identified between NLR and the presence of acidity (p=0.003). In ovarian cancer patients, there was no significant difference in NLR and MPV between malignant epithelial and malignant sex cord-stromal types (p>0.05), whereas a significant difference emerged in the PLR ratio (p=0.013).

Conclusion

In ovarian masses with malignant potential, laboratory parameters such as NLR and PLR can guide the diagnosis process. In the future, various studies such as the development of different tests, markers, and imaging methods, the use of blood tests such as NLR, PLR, and MPV in cancer diagnosis will be possible. The results of these studies may contribute to the development of new methods for the diagnosis of ovarian cancer and the improvement of treatment protocols.

Assessment on the Prognostic Validity of Dissected and Positive Lymph Node Counts and Lymph Node Ratio in Patients with Gastric Cancer: A Multi-central Cohort Study

Background: Adequate treatment for all resectable early gastric cancers (EGCs) is gastrectomy with regional lymphadenectomy. The number of positive resected lymph nodes during lymphadenectomy can be a reliable predictor of survival of GC. Objectives: We aimed at assessing the prognostic significance of Dissected Lymph Node Count (DLNC), positive LNC (PLNC), and Lymph Node Ratio (LNR) in patients with EGC. Methods: In the current retrospective cohort, 201 patients with resectable EGC were included. Demographic variables, clinicopathological characteristics of tumors (including numbers of total dissected nodes and positive, negative nodes), history of receiving adjuvant cancer therapies, and 1- and 5-year survivals were noted. Results: DLNC, PLNC, and LNR were associated with differentiation and depth of tumor, lymph node status, and risk of death (P-value for all < 0.05). There was no correlation between either of these measures with preoperative symptoms, lymphovascular invasion, and recurrence. DLNC, PLNC, and LNR showed prognostic significance only in patients, who did not receive comprehensive therapy (P-value < 0.001 for all). A significantly higher LNR was seen in patients with more than 1-year survival compared to others (P-value = 0.011). A significantly lower DLNC and higher PLNC were seen in patients, who survived over 5 years (P-value of 0.002 and 0.047, respectively). Conclusions: LNR, DLNC, and PLNC are significant prognostic factors for EGC. According to our findings, choosing the optimal approach, through which fewer negative lymph nodes are dissected, is crucial in increasing overall survival and extended lymphadenectomy cannot necessarily benefit patients.