Development and validation of a nomogram for predicting survival on the base of modified lymph node ratio in breast cancer patients

Wen, Jiahuai; Yang, Yanning; Liu, Peng; Ye, Feng; Tang, Hailin; Huang, Xiaojia; Zhong, Shaowen

doi:10.1016/j.breast.2017.01.017

Cited by 38 publications

(41 citation statements)

References 21 publications

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“…Increased scrutiny in identifying an increased number of nodes potentially results in lower LNR. 5 In other types of cancer, the prognostic value of LNR has been studied as well, [6][7][8][9] also in comparison to the TNM classification system. However, this does not yet seem to have been translated in changes in therapeutic strategies or incorporation in staging systems.…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of lymph node ratio in head and neck squamous cell carcinoma

et al. 2018

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Section: Introductionmentioning

confidence: 99%

Prognostic value of lymph node ratio in head and neck squamous cell carcinoma

et al. 2018

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“…Nomograms have been used in most cancer types in recent years [25][26][27][28][29][30][31][32] , including for ccRCC [33][34][35] . However, there has been a lack of overall evaluations of the developed nomograms, or the variables used for prediction have not been readily available.…”

Section: Discussionmentioning

confidence: 99%

A practical nomogram for predicting cancer-specific survival in patients with clear-cell renal cell carcinoma

Wen

Wang

Bai

et al. 2020

Preprint

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Background: It has limitations in predicting patient cancer-specific survival to use of the traditional American Joint Committee on Cancer (AJCC) staging system alone. Objectives: We aimed to establish and evaluate a comprehensive prognostic nomogram and compare its prognostic value with the AJCC-7th staging system in adults diagnosed with ccRCC.Methods: We used the SEER database to identify 24477 cases of ccRCC between 2010 and 2015. In the development cohort, we used multivariate Cox proportional-hazards analyses to select significant variables, and used R software to establish a nomogram for predicting the 3-year and 5-year cancer-specific survival rates of ccRCC patients. In the development and validation cohorts, we compared our cancer-specific survival model with the AJCC-7th prognosis model to evaluate the performance of the nomogram by calculating the concordance index (C-index), Youden Index, area under the receiver operating characteristic curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI), and performing calibration plotting and decision curve analyses (DCAs). Results: Eleven identified independent prognostic factors were used to establish the nomogram. Age at diagnosis, being unmarried, higher grades, larger tumor size, higher AJCC-7th stage, lymph node metastases, bone metastases, liver metastases, lung metastases, radiotherapy, and no surgery were risk factors for the cancer-specific survival of ccRCC. The C-index, Youden Index, AUC, NRI, IDI, and calibration plots demonstrated the good performance of the nomogram compared to the AJCC-7th staging system. Moreover, the 3-year and 5-year DCA curves showed that the nomogram yielded net benefits that were greater than the traditional AJCC-7th staging system. Conclusion: This study is the first to indicate that married status is an important prognostic parameter in ccRCC. Our results also demonstrate that the developed nomogram can predict cancer-specific survival more accurately than the AJCC-7th staging system alone. The prognostic factors were easily obtained.

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“…In FIGO stage I, a large number of resected lymph nodes did not represent a better outcome. The patients with [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] RLNs have the best prognosis. When RLNs numbered more than 30, the survival rate decreased.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, increasing attention has been paid to lymph node status, which can be evaluated by the number of resected lymph nodes (RLNs), 15 lymph node ratio (LNR), [16][17][18] and the log odds of positive lymph nodes (LODDS). [19][20][21][22][23][24] Compared to a single parameter, LNR exhibits its advantage in breast, [25][26][27][28] pancreatic, 19 colon, [29][30][31][32] and ovarian 16,18 cancers. Another parameter, LODDS, showed superiority in predicting outcomes in breast, 20 pancreatic, 19,21 colorectal, 22,23 and ovarian 24 cancers.…”

mentioning

confidence: 99%

Survival effect of different lymph node staging methods on ovarian cancer: An analysis of 10 878 patients

Wang

Chen

et al. 2018

Cancer Medicine

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BackgroundTo compare the survival impact of several lymph node staging methods and therapeutic role of lymphadenectomy in patients with epithelial ovarian cancer who had undergone lymphadenectomy.MethodsData were retrospectively collected from the Surveillance, Epidemiology, and End Results program between 1988 and 2013.ResultsAn increasing number of resected lymph nodes (RLNs) was associated with a significant improvement in survival of FIGO stage II and III disease. However, for FIGO stage IV patients, better survival was not significantly associated with a more extensive lymphadenectomy. A higher lymph node ratio (LNR) and log odds of positive lymph nodes (LODDS) were associated with poorer survival regardless of stage. Nevertheless, four‐category classification of LODDS was more suitable for stage IV patients when three‐category classification was compatible with stage I‐III disease. Multivariate analysis demonstrated that LODDS and LNR were significant independent prognostic factors, but not RLN classification.ConclusionSixteen to thirty RLNs are recommended for stage I disease. For stages II and III patients, the more lymph node excision, the better the prognosis. However, lymphadenectomy was nonessential for stage IV patients. Considering staging methods, for stages II and III patients, three‐category classification of LODDS was recommended to evaluate the prognosis. For stage I and IV, three‐category classification of positive LNR was idoneous.

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Development and validation of a nomogram for predicting survival on the base of modified lymph node ratio in breast cancer patients

Cited by 38 publications

References 21 publications

Prognostic value of lymph node ratio in head and neck squamous cell carcinoma

Prognostic value of lymph node ratio in head and neck squamous cell carcinoma

A practical nomogram for predicting cancer-specific survival in patients with clear-cell renal cell carcinoma

Survival effect of different lymph node staging methods on ovarian cancer: An analysis of 10 878 patients

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