Comparison of the 8th union for international cancer control lymph node staging system for gastric cancer with two other lymph node staging systems

Abstract

The log odds of positive lymph nodes (LODDS) and the metastatic lymph node ratio (MLR) staging systems have previously been demonstrated to exhibit advantages compared with the tumor-node-metastasis (TNM) staging system in predicting the prognosis of gastric cancer. The current study compared the prognostic significance of the newest Union for International Cancer Control Node classification with the LODDS and MLR staging systems. From September 2010 to December 2012, all medical records for patients with gastric cancer at the Third Affiliated Hospital of Soochow University were retrospectively analyzed and the clinicopathologic characteristics were reviewed. Cutoff points were selected to divide the patients with gastric cancer into different groups. Univariate and multivariate analyses were performed to identify the prognostic risk factors for gastric cancer. The Harrell's concordance index (C-index) was adopted to compare the prognostic value of the three staging systems. A total of 877 patients with gastric cancer who met the inclusion criteria were analyzed in the current study. The patients were classified according to the three MLR subgroups as follows: MLR0 (MLR=0), MLR1 (0<MLR≤0.28) and MLR2 (0.28<MLR<1). The patients were classified according to the LODDS subgroups as follows: LODDS1 (LODDS≤-0.5), LODDS2 (-0.5<LODDS≤0), LODDS3 (0<LODDS≤0.5) and LODDS4 (LODDS>0.5). Based on multivariate analysis, LODDS, MLR and pathological node (pN) stage could significantly predict survival rates of patients with gastric cancer. According to the C-index, the LODDS staging system more accurately predicted the 5-year overall survival for patients with gastric cancer compared with the other two staging systems. In summary, the current study has identified that LODDS may be superior to the MLR and pN staging systems in predicting the prognosis of patients with gastric cancer. However MLR may exhibit advantages compared with LODDS for patients who have undergone adequate lymphadenectomies.

Development and validation of prognostic nomogram based on log odds of positive lymph nodes for patients with gastric signet ring cell carcinoma

“…Furthermore, not only the absolute quantity of positive lymph nodes but also the amount of negative lymph nodes was taken into consideration on LODDS. So it has a better discriminatory power especially in patients with no lymph node involvement or with all lymph node involvement ( 13 - 15 ). All above, LODDS has a broad application prospect in clinical practice.…”

The Role of Alternative Lymph Node Classification Systems in Gastroenteropancreatic Neuroendocrine Neoplasms (GEP-NEN): Superiority of a LODDS Scheme Over N Category in Pancreatic NEN (pNEN)

“…The novel lymph node classification schemes were analyzed as both continuous and categorical variables. For the categorical variables, we used cut-off values and resulting subcategories proposed by 26 different studies for LNR 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 and 28 different studies for LODDS 20 21 22 23 25 26 27 28 29 31 35 38 39 40 42 43 44 45 46 47 48 49 50 51 52 53 54 55 . Proposed cut-off values published after January 19, 2021, were not included in our analysis.…”

N, LNR or LODDS: Which Is the Most Appropriate Lymph Node Classification Scheme for Patients with Radically Resected Pancreatic Cancer?

“…The novel LN classification schemes were analyzed as both continuous and categorical variables. When used as categorical variables, cut-off values and resulting subcategories as suggested by 25 different studies for LNR [ 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ] and 27 different studies for LODDS [ 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 26 , 29 , 32 , 33 , 34 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ] were used. Suggested cut-off values p...…”