Alternative staging of regional lymph nodes in gastric cancer

Szczepanik, Antoni M.; Paszko, Agata; Szura, Mirosław; Scully-Horner, Thecla; Kulig, Jan

doi:10.5114/pg.2016.61492

Cited by 7 publications

(8 citation statements)

References 27 publications

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“…We also need to pay attention to the mathematical characteristics of the LODDS score itself, which is calculated by adding a value of 0.5 to both the numerator and denominator. There is no proof that 0.5 is optimal for such an assessment [9]. As our data were obtained from a single institution, the current study may not re ect the status in other centers in China.…”

Section: Discussionmentioning

confidence: 85%

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Prognostic performance of different lymph node staging systems after curative resection for Siewert type II adenocarcinoma of the esophagogastric junction

Zhang

2020

Preprint

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Background: The tumor-node-metastasis (TNM) pN stage, which is based on the number of positive lymph nodes (LNs), is an important prognostic factor for patients with adenocarcinoma of the esophagogastric junction (AEG). The lymph node ratio (LNR) and log odds of metastatic lymph nodes (LODDS) staging systems are new effective indicators of prognosis. We aimed to evaluate their prognostic value in Siewert type II AEG.Methods: Patients diagnosed with Siewert type II AEG who underwent curative resection between 2004 and 2014 at Guangdong General Hospital were recruited. A Cox regression model was constructed, and prognostic performance was measured using Harrell’s concordance index (C-index) and the Akaike information criterion (AIC).Results: When LN status was modeled as a continuous variable, the LODDS system (C-index: 0.729; AIC: 940.483) outperformed the other staging systems, including the number of positive LNs (LNP) (C-index: 0.721; AIC: 946.935) and LNR (C-index: 0.725; AIC: 938.918).However,when assessed as categorical variables, the LNR staging system had a better prognostic performance (C-index: 0.752; AIC: 926.350) than the American Joint Committee on Cancer (AJCC) 8th edition TNM pN (C-index: 0.740; AIC: 934.349) and LODDS (C-index: 0.737; AIC: 939.087) staging systems. Each LNR stage is more evenly distributed than the other two staging systems. Moreover, the LODDS stage is more dependent on the TLNE.Conclusion: The LNR represented the best prognostic factor when assessed as a categorical variable and may serve as an alternative nodal staging system for AEG.

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Section: Discussionmentioning

confidence: 85%

“…Two positive LNs over four examined is equal to 4/8, 5/10, etc. [9] and has the ability to avoid the stage migration phenomenon [10]. Several authors have proposed that the LNR system is an independent prognostic factor and has better prognostic value than the TNM pN stage in patients with resected gastric cancer [11,12].…”

Section: Introductionmentioning

confidence: 99%

Prognostic performance of different lymph node staging systems after curative resection for Siewert type II adenocarcinoma of the esophagogastric junction

Zhang

2020

Preprint

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“…Another and more recently introduced prognostic indicator is represented by the logarithmic factor of positive lymph nodes called "Log odds of positive lymph nodes" (LODDS), which is defined as the logarithm of the ratio between the number of invaded lymph nodes and the number of negative lymph nodes (18,19,20).…”

Section: Discussionmentioning

confidence: 99%

“…Monogenic diabetes (MD) cau a single gene is a separate form of etiology, clinical presentation, therap nogenic diabetes is a heterogenous g diabetes caused by mutations in differ genes that are pivotal for pancreas d of the level of glucose for insulin se tabolism, cell membrane depolarizati synthesis/excretion [13][14][15][16][17][18][19]. Monog common, but it does account for 1 diabetes cases [20].…”

Section: Introductionmentioning

confidence: 99%

D2 Lymphadenectomy as an Independent Prognostic Factor in Gastric Cancer

Dan¹,

Catalin

Ovidiu

et al. 2020

ARS Medica Tomitana

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Background: The last decades have been marked by debates based on the importance of lymphadenectomy in gastric cancer, lymphadenectomy being a topic of controversy between the Western Surgical Societies and the Asian side. Lymphadenectomy is currently a globally accepted standard in the treatment of gastric cancer. Methods: The present study was performed prospectively on a number of 93 patients diagnosed with gastric cancer, who underwent radical gastrectomy with lymphadenectomy in the Surgery Department of the Emergency County Clinical Hospital, Constanta, between January 2012 - December 2016. In 70 cases, an extended D2 or standard D2 lymphadenectomy was performed, and for 23 patients: D1 + lymphadenectomy. The data were statistically analyzed in order to determine the prognostic value of lymphadenectomy in gastric cancer. Results: The average age was 65.88 ± 8.80 years. The mean number of lymph nodes harvested in D2 lymphadenectomy was 22.8 ± 7.60, with limits between 15 and 43, and the number of positive lymph nodes ranged from a minimum of 0 to a maximum of 37. Histopathological exam of specimens showed that only 17.2% of patients with gastric cancers were without lymph node metastases (pN0), while 45.16% were in the pN3 stage. Analysis of survival curves revealed that 5-year survival was significantly higher in D2 lymphadenectomy compared to D1 + lymphadenectomy (23.8% vs. 8.7%). Conclusions: The current study validates D2 lymphadenectomy as a standard technique and the superiority of the prognosis in gastric cancer patients through results obtained in terms of 5-year survival.

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“…The lymph node status alone may not be sufficient to show the disease. Appropriate lymph node dissection should be performed in patients with all gastric cancers [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Gastric cancer with situs inversus totalis: does it really create difficulties for surgeons?

Gündeş¹,

Çetin²,

Aday³

et al. 2018

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IntroductionSitus inversus totalis (SIT) is a very rare condition that is seen at a rate of one in about 6000–8000 births.AimTo offer a general view on the coexistence of SIT and gastric cancer, accompanied by a literature review.Material and methodsWithin the scope of this study, the case of a patient with gastric adenocarcinoma and SIT has been presented. Previous research on gastric cancer cases with SIT was reviewed through a comprehensive search of the PubMed, Medline, and Google Scholar databases. The keywords used to conduct this research were “situs inversus totalis and gastric cancer,” “situs inversus totalis and gastric malignant,” and “situs inversus totalis and gastric resection.” The database search covered English studies published between 2000 and 2016.ResultsThe results of our literature review revealed 20 studies of patients with gastric cancer and SIT, and 21 related cases. Overall, 12 of the patients were male, 9 were female, and their mean age was 61.8 ±10.97 years. The vascular assessment data showed that three out of the 13 mentioned cases had vascular anomalies. Eleven of the patients had laparoscopic resections, and one of the patients that had a surgical procedure exhibiting a postoperative mechanical obstruction.ConclusionsThe coexistence of SIT and gastric cancer is a very rare condition, and a careful preoperative radiological assessment should be conducted because there can be accompanying vascular anomalies. Laparoscopies and robotic surgeries can be performed for suitable patients at experienced centres, consistent with oncological principles.

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Alternative staging of regional lymph nodes in gastric cancer

Cited by 7 publications

References 27 publications

Prognostic performance of different lymph node staging systems after curative resection for Siewert type II adenocarcinoma of the esophagogastric junction

Prognostic performance of different lymph node staging systems after curative resection for Siewert type II adenocarcinoma of the esophagogastric junction

D2 Lymphadenectomy as an Independent Prognostic Factor in Gastric Cancer

Gastric cancer with situs inversus totalis: does it really create difficulties for surgeons?

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