A novel lymph node staging system for gastric cancer including modified Union for cancer Control/American Joint Committee on cancer and Japanese Gastric Cancer Association criteria

Gong, Yantao; Pan, Siwei; Wang, Xin; Zhu, Guolian; Xu, Hui

doi:10.1016/j.ejso.2020.06.005

Cited by 11 publications

(3 citation statements)

References 19 publications

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“…The effectiveness of the TLNRM staging system was compared with that of the eighth edition AJCC staging system in terms of prognosis discrimination. The discrimination ability of the two staging systems was quantified using the Akaike information criterion (AIC) and Bayesian information (BIC) 12 . The clinical net benefits were evaluated by decision curve analysis (DCA) and compared with those of the eighth edition of the AJCC staging system 13 .…”

Section: Methodsmentioning

confidence: 99%

A new lymph node ratio-based staging system for rectosigmoid cancer: a retrospective study with external validation

Zhang

Sun

et al. 2023

International Journal of Surgery

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Background: This study evaluated the clinical value of a new AJCC TNM staging prediction model based on lymph node ratio (LNR) in rectosigmoid cancer. Methods: The analysis included 1,444 patients with non-metastatic rectosigmoid cancer diagnosed pathologically between 2010 and 2016 who were collected from the National Cancer Institute Surveillance, Epidemiology, and Results database. The AJCC N-stage was redefined according to the LNR cut-off point, and the ability of the new staging system to predict prognosis was compared with that of the AJCC TNM staging system. Data from 739 patients from our hospital were used for external validation. Results: According to the number of examined lymph nodes and LNR, the N stage was divided into five groups (LNR0-5). The 5-year OS of patients divided according to the new TLNRM staging into stage I (T1LNR1, T1LNR2), IIA (T1LNR3, T2LNR1, T2LNR2, T2LNR3, T1LNR4, T3LNR1), IIB (T2LNR4), IIC (T3LNR2, T4aLNR1, T1LNR5), IIIA (T3LNR3, T2LNR5, T4b LNR1, T4aLNR2, T3LNR4), IIIB (T3LNR5, T4a LNR3, T4a LNR4, T4b LNR2), and IIIC (T4b LNR3, T4a LNR5, T4b LNR4, T4b LNR5) was significantly different (P<0.05). Decision curve analysis showed that the net income of the new TLNRM staging system for different decision thresholds was higher than the prediction line of the traditional 8th TNM staging system. The smaller AIC and BIC suggested that the new staging system had higher sensitivity for predicting prognosis than the traditional staging system. TLNRM Ⅱ and Ⅲ patients benefited from adjuvant chemotherapy, while adjuvant chemotherapy did not improve the prognosis of TNM Ⅱ patients. These findings were confirmed by the external validation data. Conclusion: The new TLNRM staging system was superior to the 8th edition AJCC staging system for staging and predicting the prognosis of patients with rectosigmoid cancer and may become an effective tool in clinical practice.

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Section: Methodsmentioning

confidence: 99%

A new lymph node ratio-based staging system for rectosigmoid cancer: a retrospective study with external validation

Zhang

Sun

et al. 2023

International Journal of Surgery

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“…According to the American Cancer Association staging criteria, 8th edition [14], there were 36 (21.43%) cases at stage I~II, 132 (78.57%) cases at stage III~IV, 141 (83.93%) cases with single GI bleeding and 27 (16.07%) cases with multiple bleeding. A postoperative operation was performed in 79 (47.02%) cases, including radical operation in 59 cases and palliative resection in 20 cases (Table 1).…”

Section: Clinical Diagnosis and Treatment Characteristicsmentioning

confidence: 99%

Efficacy and safety of tranexamic acid in the treatment of gastric cancer complicated with upper gastrointestinal bleeding

Bai

2024

Am J Transl Res

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Objective: To investigate the efficacy and safety of tranexamic acid (TXA) in preventing upper gastrointestinal (GI) bleeding in patients with gastric cancer. Methods: The clinical data of patients with gastric cancer complicated with acute non-operative GI bleeding treated in the Fourth Hospital of Hebei Medical University from 2020 to 2022 were collected and retrospectively analyzed. The survival status of the patients was followed up by telephone. The dataset of 168 patients was divided into a control group (n=85) and a TXA group (n=83), at a 1:1 ratio. The patients in the control group were treated with esomeprazole, and the patients in the TXA group received additional TXA. The hemostatic effect, rebleeding rate, and mortality of patients were compared between the two groups.The Cox proportional hazard model was used to evaluate the overall survival of patients as well as the related risk factors. Results: The success rate of hemostasis and the normal blood coagulation rate in the TXA group were significantly higher than those in the control group (P=0.003 and P=0.016). The secondary bleeding rate, thrombus formation rate and digestive tract perforation rate in the TXA group were significantly lower than those in the control group (P=0.002, P=0.003 and P=0.035). The improvement of all indicators in the TXA group was better than that in the control group (all P<0.05). For patients with gastric cancer complicated with acute GI bleeding treated with TXA, the Cox proportional hazard model identified III~IV stage, time of TXA treatment, surgical treatment after hemorrhage, and an increase of D-dimer as independent risk factors for upper GI bleeding (all P<0.05). Conclusion: TXA can be an effective treatment for patients with gastric cancer complicated by GI bleeding.

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“…Accordingly, topographic localization of metastatic lymph nodes predicted the 5-year overall and disease-free survival better than the eighth AJCC [ 77 ]. Similarly, anatomic location-based node stations produce better prognostic stratification than the AJCC and Japanese Gastric Cancer Association system [ 78 ]. Otherwise, if retrieving ≥16 is deemed challenging, retrieval of >13 and > 9 lymph nodes at Group 1 and 2, respectively, provides a more accurate prognosis prediction and minimizes staging migration [ 79 ].…”

Section: Impact Of Retrieved Lymph Node Number and Lymph-node Ratio I...mentioning

confidence: 99%

Revisiting the 8th AJCC system for gastric cancer: A review on validations, nomograms, lymph nodes impact, and proposed modifications

Mranda

Xiang

Zhou

et al. 2022

Annals of Medicine &Amp; Surgery

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A novel lymph node staging system for gastric cancer including modified Union for cancer Control/American Joint Committee on cancer and Japanese Gastric Cancer Association criteria

Cited by 11 publications

References 19 publications

A new lymph node ratio-based staging system for rectosigmoid cancer: a retrospective study with external validation

A new lymph node ratio-based staging system for rectosigmoid cancer: a retrospective study with external validation

Efficacy and safety of tranexamic acid in the treatment of gastric cancer complicated with upper gastrointestinal bleeding

Revisiting the 8th AJCC system for gastric cancer: A review on validations, nomograms, lymph nodes impact, and proposed modifications

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