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Superiority of lymph node ratio-based staging system for prognostic prediction in 2575 patients with gastric cancer: validation analysis in a large single center.
- Source :
-
Oncotarget [Oncotarget] 2016 Aug 09; Vol. 7 (32), pp. 51069-51081. - Publication Year :
- 2016
-
Abstract
- This study aimed to evaluate the prognostic significance of node ratio (Nr), the ratio of metastatic to retrieved lymph nodes, and to investigate whether a modified staging system based on Nr can improve prognostic ability for gastric cancer patients following gastrectomy. A total of 2572 patients were randomly divided into training set and validation set, and the cutoff points for Nr were produced using X-tile. The relationships between Nr and other clinicopathologic factors were analyzed, while survival prognostic discriminatory ability and accuracy were compared among different staging systems by AIC and C-index in R program. Patients were categorized into four groups as follows: Nr0, Nr1: 0.00-0.15, Nr2: 0.15-0.40 and Nr3: > 0.40. Nr was significantly associated with clinicopathologic factors including macroscopic type, tumor differentiation, lymphovascular invasion, perineural invasion, tumor size, T stage, N stage and TNM stage. Besides, for all patients, Nr and TNrM staging system showed a smaller AIC and a larger C-index than that of N and TNM staging system, respectively. Moreover, in subgroup analysis for patients with retrieved lymph nodes < 15, Nr was demonstrated to have a smaller AIC and a larger C-index than N staging system. Furthermore, in validation analysis, Nr, categorized by our cutoff points, showed a larger C-index and a smaller AIC value than those produced in previous studies. Nr could be considered as a reliable prognostic factor, even in patients with insufficient (< 15) retrieved lymph nodes, and TNrM staging system may improve the prognostic discriminatory ability and accuracy for gastric cancer patients undergoing radical gastrectomy.<br />Competing Interests: The authors declare no potential conflicts of interest.
- Subjects :
- Adult
Aged
Aged, 80 and over
Female
Gastrectomy
Humans
Lymph Node Excision
Lymph Nodes pathology
Lymphatic Metastasis
Male
Middle Aged
Neoplasm Staging standards
Prognosis
Retrospective Studies
Stomach Neoplasms mortality
Survival Analysis
Neoplasm Staging methods
Stomach Neoplasms diagnosis
Stomach Neoplasms pathology
Stomach Neoplasms surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1949-2553
- Volume :
- 7
- Issue :
- 32
- Database :
- MEDLINE
- Journal :
- Oncotarget
- Publication Type :
- Academic Journal
- Accession number :
- 27363014
- Full Text :
- https://doi.org/10.18632/oncotarget.9714