Lymphatic metastasis is an important prognostic factor for pancreatic cancer. However, lymphatic metastatic status (N0 or N1) can not reflect the degree of lymphatic metastasis. Lymph node ratio, which is defined as the number of positive lymph nodes divided by total examined lymph nodes, can reflect the degree of lymph metastatic metastasis and give consi deration to examined lymph nodes. Lymph node ratio is superior to lymph metastatic status in staging, guiding treatment, and predicting prognosis. However, currently, lymph node ratio cannot replace lymph metastatic status for the undetermined minimum number of examined lymph nodes and cutoff value. Further evidence is needed to prove its clinical value.
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