Linking new lymph node staging methods to better survival outcomes in gastric cancer enhances surgical decision-making.

• The lymph node ratio (lnr) and log odds of positive nodes (lodds) significantly predict survival alongside traditional pN staging (p=0.002 and p=0.036).
• In cases with fewer than 15 lymph nodes dissected, only lnr remains prognostic (p=0.037).

Using lnr and lodds can refine patient selection and staging, especially for those with inadequate lymph node dissection.