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Lymph nodes ratio based nomogram predicts survival of resectable gastric cancer regardless of the number of examined lymph nodes

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机构: [1]Collaborat Innovat Ctr Canc Med, State Key Lab Oncol South China, Guangzhou, Guangdong, Peoples R China; [2]Jiangxi Canc Hosp, Dept Abdominal Surg, Nanchang, Jiangxi, Peoples R China; [3]Anhui Prov Canc Hosp, West Branch Anhui Prov Hosp, Dept Breast Surg, Hefei, Peoples R China; [4]Sun Yat Sen Univ, Dept Hematol Oncol, Canc Ctr, Guangzhou, Guangdong, Peoples R China; [5]Sun Yat Sen Univ, Canc Ctr, Dept Gastr & Pancreat Surg, Guangzhou, Guangdong, Peoples R China
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关键词: nomogram gastric cancer curative resection lymph nodes ratio prognosis

摘要:
To develop a nomogram to predict the prognosis of gastric cancer patients on the basis of metastatic lymph nodes ratio (mLNR), especially in the patients with total number of examined lymph nodes (TLN) less than 15. The nomogram was constructed based on a retrospective database that included 2,205 patients underwent curative resection in Cancer Center, Sun Yat-sen University (SYSUCC). Resectable gastric cancer (RGC) patients underwent curative resection before December 31, 2008 were assigned as the training set (n = 1,470) and those between January 1, 2009 and December 31, 2012 were selected as the internal validation set (n = 735). Additional external validations were also performed separately by an independent data set (n = 602) from Jiangxi Provincial Cancer Hospital (JXCH) in Jiangxi, China and a data set (n = 3,317) from the Surveillance, Epidemiology, and End Results (SEER) database. The Independent risk factors were identified by Multivariate Cox Regression. In the SYSUCC set, TNM (Tumor-node-metastasis) and TRM-based (Tumor-Positive Nodes Ratio-Metastasis) nomograms were constructed respectively. The TNM-based nomogram showed better discrimination than the AJCC-TNM staging system (C-index: 0.73 versus 0.69, p < 0.01). When the mLNR was included in the nomogram, the C-index increased to 0.76. Furthermore, the C-index in the TRM-based nomogram was similar between TLN >= 16 (C-index: 0.77) and TLN = 15 (C-index: 0.75). The discrimination was further ascertained by internal and external validations. We developed and validated a novel TRM-based nomogram that provided more accurate prediction of survival for gastric cancer patients who underwent curative resection, regardless of the number of examined lymph nodes.

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出版当年[2017]版:
大类 | 2 区 医学
小类 | 2 区 肿瘤学 3 区 细胞生物学
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第一作者机构: [1]Collaborat Innovat Ctr Canc Med, State Key Lab Oncol South China, Guangzhou, Guangdong, Peoples R China;
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通讯机构: [1]Collaborat Innovat Ctr Canc Med, State Key Lab Oncol South China, Guangzhou, Guangdong, Peoples R China; [5]Sun Yat Sen Univ, Canc Ctr, Dept Gastr & Pancreat Surg, Guangzhou, Guangdong, Peoples R China
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