SynthesisFrontiers in oncology2026
Prognostic value of lymph node ratio after neoadjuvant chemotherapy for gastric cancer: a systematic review and meta-analysis.
Synthesis in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- A prognostic nomogram based on log odds of positive lymph nodes to predict survival in gastric cancer patients with neoadjuvant chemotherapy: a large population-based cohort study and external validation.Journal of gastrointestinal oncology · 2026Article
- The prognostic value of log odds of positive lymph nodes in patients with resectable locally advanced gastric cancer following neoadjuvant therapy: results from the SEER database.Translational cancer research · 2026Article
- Prognostic Significance and Functional Role of PPIB in a Retrospective Cohort of Patients with Advanced Gastric Cancer.Oncology research · 2026Article
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8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Background: The prognostic value of the lymph node ratio (LNR) in gastric cancer treated with neoadjuvant chemotherapy (NACT) remains unclear, as conventional pathological nodal assessment after neoadjuvant therapy may be affected by treatment-induced changes. This meta-analysis evaluated whether LNR retains prognostic significance in patients undergoing neoadjuvant chemotherapy followed by curative gastrectomy. Methods: PubMed, MEDLINE, CENTRAL, Web of Science, Embase, and ClinicalTrials.gov were searched from inception to October 20, 2025. Retrospective cohort studies reporting hazard ratios (HRs) for survival outcomes based on LNR after NACT were included. Overall survival was the primary outcome; disease-free survival was a secondary outcome. Prespecified subgroup analyses were performed by LNR cutoff (≥0.30 Results: Seven studies involving 2,437 patients met inclusion criteria. Six studies reported overall survival, one study reported disease-specific survival. High LNR was strongly associated with poorer overall survival (OS)(HR = 3.48, 95% CI: 2.27-5.33) and inferior disease-free survival(DFS) (HR = 1.94, 95% CI: 1.24-3.06). Subgroup analysis showed a significant interaction by LNR cutoff (p = 0.03), but no interaction by neoadjuvant treatment modality (p = 0.49). Sensitivity analyses confirmed the stability of results. Conclusions: Higher LNR is a strong and independent predictor of poor survival after neoadjuvant chemotherapy in gastric cancer. LNR may improve postoperative risk stratification beyond pathological TNM staging after neoadjuvant therapy, but prospective studies are required to establish optimal cut-offs and determine how LNR should be integrated into clinical decision-making. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD420251233582.
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