Objective:To compare the prognostic accuracy among three gastric cancer lymph node staging systems(pN,MLR and LODDS). Methods:Total 1 247 gastric cancer patients who received radical resection with complete follow-up data were included. ROC curves of Three Lymph Node Staging Systems were plotted and the area under curve(AUC)were statistically analyzed by grouped t test. Results:In the overall sample, samples with T2 or T3 stage,and samples with <15 or ≥ 15 nodes retrieved,all the three staging systems had prognostic value,but no statistical difference was found among AUCs of those three staging systems. Only LODDS had prognostic value in the sample without node metastasis and sample with T1 stage. However,in the sample with lymph node metastasis,all three had prognostic value,and the AUC differences between MLR and pN,LODDS and pN were statistically significant. Conclusion:The prognosic accuracy of MLR and LODDS is better than pN; MLR and pN are not able to predict prognosis of early gastric cancer;LODDS is the most accurate lymph node staging system for predicting the prognosis of gastric cancer.