The RML of lymph node metastasis was superior to the LODDS for evaluating the prognosis of gastric cancer

Liu, Honggen; Deng, Jingyu; Zhang, Rupeng; Hao, Xishan; Jiao, Xuguan; Liang, Han

doi:10.1016/j.ijsu.2013.03.009

Cited by 45 publications

(34 citation statements)

References 24 publications

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“…The number-based lymph node staging system of UICC classification (seventh edition) was widely used, although a principle flaw is that the prognostic accuracy is influenced by the number of total retrieved lymph nodes [8, 9]. The most recent NCCN guideline recommends that D2 lymphadenectomy should be used to remove an adequate number of lymph nodes (no less than 15); however, some studies reported that ≥15 lymph nodes are harvested in only 29 and 60.2 % of cases in the USA [10] and China [11]. Moreover, the optimal number of retrieved lymph nodes to avoid stage migration remains unclear in some studies [12, 13].…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of three different lymph node staging systems in the survival of patients with gastric cancer following D2 lymphadenectomy

et al. 2016

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The log odds of positive lymph nodes (LODDS) was defined as the log of the ratio between the number of positive lymph nodes and the number of negative lymph nodes, which is a novel and promising nodal staging system for gastric cancer. Here, we aimed to compare the prognostic effect of pN, lymph node ratio (LNR) and LODDS. The association between overall survival and pN, LNR and LODDS was retrospectively analysed. The discriminatory ability and monotonicity of gradients (linear trend χ 2 score), homogeneity ability (likelihood ratio test) and prognostic stratification ability (Akaike information criterion [AIC] and receiver operating characteristic [ROC] curve) were compared among three lymph node staging systems. The pN, LNR and LODDS were all identified as independent prognostic factors for gastric cancer patients in the multivariate analysis. LODDS showed the best prognostic performance (linear trend χ 2 score 266.743, likelihood ratio χ 2 test score 427.771, AIC value 5670.226, area under the curve (AUC) 0.793), followed by LNR and pN. In patients with different levels of retrieved lymph nodes (≤10, 11–14, 15–25 and >25), LODDS was the most powerful for prognostic prediction and discrimination of the heterogeneity among the subgroups. Significant differences in survival were observed among patients in different LODDS subgroups after being classified according to the pN and LNR classifications. LODDS appears to be a more powerful system for predicting the overall survival of gastric cancer patients, as compared to LNR and pN, and may serve as an alternative nodal staging system for gastric cancer.

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Section: Discussionmentioning

confidence: 99%

Prognostic value of three different lymph node staging systems in the survival of patients with gastric cancer following D2 lymphadenectomy

et al. 2016

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“…20 Additionally, in the study of Sun et al, the LODDS staging system was shown to be superior to pN and LNR classifications, but this was restricted to patients in whom an insufficient number of LNs were retrieved. 18 Two other studies that compared LN staging systems did not demonstrate superiority of LODDS over LNR, 22,23 but in one of them, only patients with more than 15 LNs analyzed were included. 22 Some studies have previously reported that the LNR staging system can also be useful to discriminate prognosis among pN1 and pN2 patients even when fewer than 15 LNs are analyzed.…”

Section: Discussionmentioning

confidence: 99%

“…18 Two other studies that compared LN staging systems did not demonstrate superiority of LODDS over LNR, 22,23 but in one of them, only patients with more than 15 LNs analyzed were included. 22 Some studies have previously reported that the LNR staging system can also be useful to discriminate prognosis among pN1 and pN2 patients even when fewer than 15 LNs are analyzed. 16,17 However, the LNR system can only differentiate prognoses between patients with positive LNs; moreover, the LNR seems not accurate enough in discriminating survival rates from patients in which all LNs are metastatic.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, using a log-rank pairwise comparison, the LODDS categories were able to discriminate subgroups in pN stages and LNR categories with different prognoses. Since Sun et al emphasized the value of LODDS for prognostic assessment of LN metastasis in gastric cancer, 18 some recent reports have compared pN classification to LNR and LODDS staging systems[19][20][21][22][23] with disappointing conclusions, most likely due to the use of different statistical tools for assessment. While some of these studies have certified a superiority of LODDS staging discriminating patients with the same pN or LNR categories but having different survival rates, 18-20 others did not find a superiority of LODDS over pN 21 or LNR 22,23.…”

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confidence: 99%

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Usefulness of the Log Odds of Positive Lymph Nodes to Predict and Discriminate Prognosis in Gastric Carcinomas

Calero

Escrig-Sos

Mingol

et al. 2015

Journal of Gastrointestinal Surgery

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“…The prognostic significance of a number of clinical parameters has been examined for patients with GC subsequent to radical surgery (8)(9)(10)(11)(12)(13)(14)(15). Of these, the preoperative prognostic nutritional index (PNI) as a reflection of the immunological and nutritional condition of the patients has been associated with the outcomes of patients who undergo gastrectomy for a number of stages of GC (10,11,16,17).…”

Section: Introductionmentioning

confidence: 99%

Outcome predictors for patients with stage II/III gastric cancer who undergo gastrectomy and S-1 adjuvant chemotherapy

et al. 2017

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Abstract. Predictors of survival in patients with stage II/III gastric cancer (GC) who received tegafur/gimeracil/oteracil (S-1) adjuvant chemotherapy (ACT) subsequent to gastrectomy were examined. Additionally, the association between dose intensity of S-1 and survival rate was investigated. A total of 62 patients with stage II/III gastric cancer were retrospectively evaluated, each of whom had received a curative D2 gastrectomy and S-1 ACT. The relative performance (RP; administered/planned S-1 doses x100%), body mass index (BMI), prognostic nutritional index (PNI) and body weight (BW) were calculated, and the association of survival with these factors and other clinicopathological parameters was examined. The 1-year treatment continuation rate for S-1 was 94.2%, excluding patients who experienced cancer recurrences during their ACT year. The initial S-1 reduction rate was 38.7%. Patients with stage II/IIIA disease exhibited significantly improved 5-year overall survival rates compared with patients with stage IIIB GC, 81.6/73.7 vs. 33.8% (P<0.01). No association between RP and survival was observed. BMI, BW and PNI were significantly decreased following surgery compared with preoperative states. In the univariate analysis, postoperative BW loss (BMI loss), pathological stage and >7 lymph node metastases were significantly associated with outcome (P<0.05); in the multivariate analysis, postoperative BW loss >10.6% and pathological stages were independent prognostic factors for survival. Continuing S-1 ACT for the full year exhibited a greater effect on survival compared with dosage. Early postoperative nutritional deterioration may decrease the survival rates in these patients.

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The RML of lymph node metastasis was superior to the LODDS for evaluating the prognosis of gastric cancer

Abstract: RML staging was the best system for prediction the OS of the gastric cancer patients following radical gastrectomy plus extended lymphadenectomy, rather than LODDS staging, NLN staging or N staging.

Cited by 45 publications

References 24 publications

Prognostic value of three different lymph node staging systems in the survival of patients with gastric cancer following D2 lymphadenectomy

Prognostic value of three different lymph node staging systems in the survival of patients with gastric cancer following D2 lymphadenectomy

Usefulness of the Log Odds of Positive Lymph Nodes to Predict and Discriminate Prognosis in Gastric Carcinomas

Outcome predictors for patients with stage II/III gastric cancer who undergo gastrectomy and S-1 adjuvant chemotherapy

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