最近描述了几种用于胃癌的替代淋巴结分期系统。一些研究人员指出，在预测胃癌患者的预后方面，淋巴结阳性对数几率 (LODDS) 系统可能优于 pN 分期（美国癌症联合委员会）和淋巴结比率系统。然而，大多数研究是在亚洲国家进行的，其他研究人员报告的结果相互矛盾。我们对2000年至2019年间在西班牙一家三级医院切除的所有377例胃癌进行了回顾性研究。收集了临床病理特征，计算LODDS并分为5组（S1-S5），并进行统计分析。纳入病例（n = 315）分为S1（25.6%）、S2（18.4%）、S3（21.3%）、 S4 (20.3%) 和 S5 (14.4%)。 LODDS 分类与肿瘤大小、Lauren 亚型、印戒细胞的存在、肿瘤分级、神经周围浸润、淋巴血管侵犯、生长模式、pT、肿瘤复发和死亡显着相关。基于 LODDS 分类的 Kaplan-Meier 分析表明，与 pN 分期相比，总生存期 (OS) 和无病生存期 (DFS) 的患者分层得到了改善。复发和死亡的曲线下面积值优于 LODDS 分类，并且该分类与 OS 和 DFS 独立相关。此外，LODDS分类成功地将无淋巴结转移（pN0）的患者分为具有不同预后的亚组。对于我们的队列，LODDS系统显示出比pN分期更好的预后表现；它是 OS 和 DFS 的独立预测因子，并且为无淋巴结转移的病例提供了有价值的预后信息。然而，在切除少于 16 个淋巴结的病例中，其预后准确性会降低。© 作者 2023。由牛津大学出版社代表美国临床病理学会出版。版权所有。如需权限，请发送电子邮件至：journals.permissions@oup.com。

Several alternative lymph node staging systems have recently been described for gastric cancer. The log odds of positive lymph nodes (LODDS) system may be superior to the pN stage (American Joint Committee on Cancer) and lymph node ratio systems in predicting outcomes for patients with gastric cancers, as indicated by some researchers. Most studies, however, have been conducted in Asian countries, and conflicting results have been reported by other investigators.We conducted a retrospective study of all 377 cases of gastric cancer resected at a tertiary hospital in Spain between 2000 and 2019. Clinicopathologic features were collected, LODDS were calculated and categorized into 5 groups (S1-S5), and statistical analysis was performed.The cases included (n = 315) were classified as S1 (25.6%), S2 (18.4%), S3 (21.3%), S4 (20.3%), and S5 (14.4%). The LODDS classification was significantly associated with tumor size, Laurén subtype, presence of signet ring cells, tumor grade, perineural infiltration, lymphovascular invasion, growth pattern, pT, tumor recurrence, and death. Kaplan-Meier analysis based on the LODDS classification demonstrated improved patient stratification compared with the pN stage for both overall survival (OS) and disease-free survival (DFS). Area under the curve values for recurrence and death were superior for the LODDS classification, and this classification was independently related to OS and DFS. In addition, the LODDS classification successfully divided patients without lymph node metastases (pN0) into subgroups with distinct prognoses.For our cohort, the LODDS system showed better prognostic performance than pN stage; it was an independent predictor of OS and DFS, and it provided valuable prognostic information in cases without lymph node metastases. Its prognostic accuracy, however, decreased in cases with fewer than 16 lymph nodes resected.© The Author(s) 2023. Published by Oxford University Press on behalf of American Society for Clinical Pathology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.