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Comparison of prognostic nomograms based on different nodal staging systems in patients with resected gastric cancer

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机构: [1]Sun Yat Sen Univ, Canc Ctr, Dept Med Oncol, 651 Dong Feng Rd East, Guangzhou 510060, Guangdong, Peoples R China; [2]State Key Lab Oncol South China, 651 Dong Feng Rd East, Guangzhou 510060, Guangdong, Peoples R China; [3]Collaborat Innovat Ctr Canc Med, 651 Dong Feng Rd East, Guangzhou 510060, Guangdong, Peoples R China; [4]Johns Hopkins Univ, Dept Pathol, Sch Med, Baltimore, MD 21231 USA; [5]Southern Med Univ, Nanfang Hosp, Dept Gen Surg, 1838 North Guangzhou Ave, Guangzhou 510515, Guangdong, Peoples R China; [6]Sun Yat Sen Univ, Canc Ctr, Dept Gastr & Pancreat Surg, 651 Dong Feng Rd East, Guangzhou 510060, Guangdong, Peoples R China
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关键词: gastric cancer nomogram metastatic lymph node (MLN) count lymph node ratio (LNR) log odds of metastatic lymph nodes (LODDS)

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Purpose: Previous studies addressing the optimal nodal staging system in patients with resected gastric cancer have shown inconsistent results, and the optimal system for development of prognostic nomograms remains unclear. In this study, we compared prognostic nomograms based on the metastatic lymph node (MLN) count, lymph node ratio (LNR), and log odds of metastatic lymph nodes (LODDS) to predict the 5-year overall survival in patients with resected gastric cancer. Methods: We analysed 15,320 patients with resected gastric cancer in the Surveillance, Epidemiology, and End Results (SEER) database between 1988 and 2010. Missing data were handled using multiple imputation. When assessed as a continuous covariate with restricted cubic splines, each MLN, LNR, and LODDS variable was incorporated into a nomogram with other significant prognosticators to predict the 5-year overall survival. A two-centre Chinese dataset (1,595 cases) was used as external validation data. Results: The discriminatory abilities of the MLN-,LNR-, and LODDS-based nomograms were comparable (concordance indices: 0.744, 0.741, and 0.744, respectively, in the SEER set, P > 0.152 for all pairwise comparisons; 0.715, 0.712, and 0.713, respectively, in the Chinese set, P > 0.445 for all pairwise comparisons). The discriminatory abilities of the three nomograms were all superior to the American Joint Committee on Cancer (AJCC) TNM classification (concordance indices: 0.713, P < 0.001 for all in the SEER set; and 0.693, P < 0.001 for all in the Chinese set). The discriminatory abilities of the nomograms were comparable regardless of the number of nodes examined. Moreover, decision curve analyses indicated similar net benefits of using the nomograms. Conclusion: MLN-, LNR-, and LODDS should be considered equally in the development of multivariate prognostic models and nomograms to refine the prediction of survival among patients with resected gastric cancer.

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出版当年[2017]版:
大类 | 3 区 医学
小类 | 3 区 肿瘤学
最新[2023]版:
大类 | 3 区 医学
小类 | 4 区 肿瘤学
第一作者:
第一作者机构: [1]Sun Yat Sen Univ, Canc Ctr, Dept Med Oncol, 651 Dong Feng Rd East, Guangzhou 510060, Guangdong, Peoples R China; [2]State Key Lab Oncol South China, 651 Dong Feng Rd East, Guangzhou 510060, Guangdong, Peoples R China; [3]Collaborat Innovat Ctr Canc Med, 651 Dong Feng Rd East, Guangzhou 510060, Guangdong, Peoples R China;
通讯作者:
通讯机构: [1]Sun Yat Sen Univ, Canc Ctr, Dept Med Oncol, 651 Dong Feng Rd East, Guangzhou 510060, Guangdong, Peoples R China; [2]State Key Lab Oncol South China, 651 Dong Feng Rd East, Guangzhou 510060, Guangdong, Peoples R China; [3]Collaborat Innovat Ctr Canc Med, 651 Dong Feng Rd East, Guangzhou 510060, Guangdong, Peoples R China; [5]Southern Med Univ, Nanfang Hosp, Dept Gen Surg, 1838 North Guangzhou Ave, Guangzhou 510515, Guangdong, Peoples R China;
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